Health Outcomes Associated With Internalizing Problems in Early Childhood and Adolescence

Emotional reactivity mediates and moderates the longitudinal associations between mothers' depressive symptoms and behavioral problems in youth

Despite the well-established link between mothers' depressive symptoms and youth behavioral problems, it remains unclear whether the mechanism by which mothers' depressive symptoms promote behavioral problems may also be related to individual differences in this relation. Following the three-variable system integrating mediation and moderation, this study used an integrative model to simultaneously examine the mediating and moderating role of emotional reactivity in the longitudinal associations between maternal depressive symptoms and internalizing and externalizing problems in youth. Participants were 1060 youth and their mothers from the NICHD Study of Early Child Care and Youth Development (49.7% boys, 81.6% white). Mothers reported their own depressive symptoms at nine waves from infancy through the fifth grade. They also rated adolescents' emotional reactivity in the fifth grade and behavioral problems in the fifth and sixth grades. The results showed that emotional reactivity mediated the longitudinal relations between maternal depressive symptoms and internalizing and externalizing problems in youth. The results also supported the moderation of emotional reactivity. That is, mothers' depressive symptoms were associated with high levels of internalizing and externalizing problems, particularly among youth who were high in emotional reactivity. The findings highlight the dual role of emotional reactivity to better understand the associations between mothers' depressive symptoms and offspring behavioral problems, and emphasize the need to target emotional reactivity to alleviate the adverse impacts of maternal depressive symptoms on behavioral adjustment in early adolescence.

Promoting Resilience in Youth through Mindfulness mEditation (PRYME): Study protocol for a randomized controlled trial investigating the effects of mindfulness training as add-on to care-as-usual on internalizing problems, mental illness development, and associated brain and cognitive processes in help-seeking youth

BACKGROUND

Internalizing problems, such as worrying, anxiety and low mood, are increasingly common in youth and may constitute an early stage of mental illness development. There is thus an urgent need for effective measures to address mental health complaints as they develop and to prevent progression into more serious mental illness. Enhanced understanding of early-stage mental illness development, associated cognitive and brain processes, and their amenability to early intervention is crucial to this effort. Mindfulness-based interventions offer an accessible intervention option with demonstrated positive effects on internalizing disorders such as depression. Furthermore, mindfulness-based interventions may modulate cognitive processes and brain activity patterns associated with internalizing disorders. This study aims to determine how early-stage mindfulness-based intervention impacts internalizing symptom development, associated cognitive and brain processes, and mental illness progression in help-seeking youth.

METHODS

This longitudinal two-arm randomized controlled trial will be conducted in 155 help-seeking youth between 16 and 25 years of age. The investigational treatment, the Learning to Offset Stress program, is an adaptation of existing mindfulness-based programs. Developed for youth with internalizing problems, the training combines mindfulness exercises with mindful physical activity and yoga in 8 weekly 2-hour sessions. Participants are randomized to either Learning to Offset Stress program as an add on to care-as-usual, or care-as-usual-only. Assessments take place at baseline, end of treatment, and 2 months and 6 months after completion of treatment. The primary outcome is the level of internalizing problems measured with the internalizing subscale of the Adult Self Report questionnaire at end of treatment. Secondary outcomes include measures of self-compassion, rumination, experiential avoidance, and well-being. In addition, (functional) magnetic resonance imaging and computerized cognitive tasks are conducted at baseline and at end of treatment.

DISCUSSION

The current randomized controlled trial aims to enhance our understanding of the trajectory of emerging mental illness, associated cognitive and brain processes, and their modulation by early-stage mindfulness-based intervention.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05916651. Registered on 23 June 2023.

Impacts of a tiered intervention on child internalizing and externalizing behavior in the context of maternal depression

Greater maternal depressive symptoms are consistently associated with higher levels of behavioral difficulties in children, emerging in early childhood and with long-lasting consequences for children's development. Interventions promoting early relational health have been shown to have benefits for children's behavior; however, these impacts are not always realized in the context of maternal depression. This study examined whether tiered programs could address this limitation by focusing on both parenting, through universal primary prevention, and psychosocial stressors and parent mental health, through tailored secondary prevention. Analysis of a randomized controlled trial (RCT) of the Smart Beginnings (SB) intervention was conducted to determine whether SB attenuated the association between maternal depression and early childhood internalizing and externalizing behaviors. Maternal depression significantly predicted both internalizing and externalizing behaviors in linear regression models. Further, there was a significant interaction between maternal depression and treatment group, such that among mothers with higher depressive symptoms, the SB treatment attenuated the magnitude of the association between depression and child behavior. Findings suggest that while parenting support is important for all families, it may be particularly critical for those with higher levels of depression and underscores the need to consider multidimensional family processes in both research and clinical practice.

The impact of sleep problems during late childhood on internalizing problems in early-mid adolescence

OBJECTIVES

Sleep and internalizing problems escalate during adolescence and can negatively impact long-term health. However, the directionality of this risk-relationship remains poorly understood within a developmental context. The current study aimed to determine the directionality of this relationship in adolescents with no history of psychiatric disorder and whether sex at birth played a role in this relationship.

METHODS

We used data from the Adolescent Brain Cognitive Development, an ongoing multisite longitudinal US study, that covered four waves (W1:9-11 years; W2:10-12 years; W3:11-13 years; W4:12-14 years). Analyses included 3,128 youth (50.99%girls) with no past or current psychiatric disorders at W1. The Sleep Disturbance Scale for Children and the Child Behavior Checklist were used to measure sleep and internalizing problems. Cross-lagged panel models were used to evaluate the cross-lagged relationships across waves.

RESULTS

The sleep-internalizing cross-lagged relationship was unidirectional, with medium-large effect sizes: greater total sleep problems were associated with more severe internalizing problems at later waves (W2➔W3, coefficient = 0.052, p = .021; W3➔W4, coefficient = 0.091, p < .001), with problems in initiating and maintaining sleep predicting internalizing problems early on. Girls showed greater sleep-internalizing risk than boys.

CONCLUSIONS

Sleep-internalizing relationships change across adolescence, becoming significant and more specific from early to mid-adolescence. Sleep interventions delivered in early adolescence, to girls in particular, may have a positive short and long-term impact on internalizing outcomes.

The Relationship between Coping Strategies and Internalizing and Externalizing Problems of Bullied Students: The Moderating Role of Classroom Discipline Management

Bullying has become a worldwide concern, and is particularly serious in vocational high schools in China. The bullied students typically resort to coping strategies to mitigate its adverse consequences. However, there is a lack of research on which bullying coping strategies might mitigate the negative effects of bullying on students and which types of classroom discipline management might play a moderating role. The participants were 1483 students from a vocational high school. The Olweus Bully/Victim Questionnaire was used to identify 251 students who had experienced bullying. The results showed that: cognitive distancing significantly negatively predicted the externalizing problems of bullied students, while revenge seeking significantly positively predicted their externalizing problems. Seeking adult support and cognitive distancing significantly and negatively predicted the internalizing problems, while passive coping significantly positively predicted their internalizing problems. Discipline management played a moderating role in the relationship between coping strategies and externalizing problems. These findings suggest that seeking support from teachers and parents through open communication is encouraged, as it was shown to reduce internalizing problems. While cognitive distancing may offer temporary relief, revenge seeking and passive coping had detrimental effects on externalizing or internalizing problems. Positive disciplinary management mitigated externalizing problems for bullied students who used passive coping. However, punitive management potentially exacerbated externalizing problems for students who sought revenge. Furthermore, SEL programs only benefited those with low levels of passive coping. Special attention needs to be paid to bullied students who use passive coping or seek revenge, and guide them toward more adaptive responses.

Longitudinal predictors for internalizing and externalizing symptomatology at age 4: KUNO-Kids cohort study

Introduction

Numerous early-life risk factors are thought to significantly contribute to the development of psychological problems in toddlerhood. However, these factors have seldom been investigated concomitantly and longitudinally, and few studies include both mothers and fathers. This study examines the longitudinal impact of early environmental, parental, and child-specific risk factors on children's internalizing and externalizing symptomatology at age 4.

Methods

Families were recruited from a perinatal center at birth and completed self-report questionnaires at birth, 4 weeks postpartum, 6 months postpartum, and annually thereafter. The final population-based sample consisted of n = 560 mothers (and fathers) who gave birth after June 2015, with children who turned 4 years old before March 31, 2021. The primary outcomes, children's internalizing and externalizing symptomatology at age 4, were measured using the Strengthsand Difficulties Questionnaire. Linear mixed effect models were used to estimate growth curves for predictors between 4 weeks and 4 years postpartum, which were subsequently entered into multivariable linear regressions to predict internalizing and externalizing symptomatology at age 4.

Results

The study identified several key risk factors: environmental (lack of social support, lower parental education, male sex), parental (poor parental mental health, increased parenting stress, parental sleep difficulties) and child-specific (children's low physical health, children's reduced sleep quality, temperament).

Discussion

The findings underscore that most identified risk factors are related to children's temperament, mental and physical health of parents, their experienced stress, and families' social support networks. These insights highlight the importance of targeted interventions focusing on improving parental mental health, reducing stress, and enhancing social support to mitigate early-life psychological problems in children.

Multisystemic Resilience and Anxious-Depressed Symptoms in Black Youth Exposed to Maternal Syndemics: A Mixed-Method Study

We explored associations between multisystemic resilience and anxious-depressed symptoms in Black families experiencing maternal syndemics (i.e., co-occurring epidemics of substance abuse, violence, HIV/AIDS), using a sequential explanatory study design. Hierarchical regression was used to analyze data from 171 Black youth (57% girls; Mage=12.13, SD = 2.90). Girls (β=-0.17, p = .02) with higher inter/intrapersonal skills (β = - 0.28, p = .004) and more open familial communication (β = - 0.40, p < .001) reported fewer anxious-depressed symptoms, F(12, 147) = 5.68; p < .001, Adj R2 = 26.1%. Qualitative results from a subsample of 10 Black youth-mother dyads explored inter/intrapersonal factors (i.e., emotion regulation strategies, goal setting, persistence and perseverance, problem-solving skills) and open communication factors (i.e., comfortable environment to talk, solving problems, processing feelings, showing affection, benefiting from open communication) that support Black youth resilience. Findings highlight key resilience factors that could be bolstered in future interventions to reduce anxious-depressed symptoms among Black youth exposed to maternal syndemics.

Alexithymia as a mediator of the associations between child maltreatment and internalizing and externalizing behaviors in adolescence

Child maltreatment is a global concern that profoundly affects individuals throughout their lives. This study investigated the relationships between various forms of child maltreatment and behavior problems involving internalization and externalization during adolescence. Data obtained from a diverse sample of 1802 Canadians aged 14-18 years was used to examine the mediating role of alexithymia-a difficulty in recognizing and expressing emotions-in these associations. Results indicated that adolescents who experienced sexual abuse, emotional abuse, and exposure to intimate partner violence (IPV) in their childhood exhibited higher levels of alexithymia, which was correlated with elevated levels of both internalizing and externalizing problems. Physical abuse and parental neglect were only associated with externalizing problems. Gender differences also emerged, with gender-diverse adolescents reporting a higher prevalence of maltreatment, alexithymia, and behavior problems compared with their peers. However, alexithymia's mediating role was consistent across genders. Overall, this study highlights the intricate relationships between child maltreatment, alexithymia, and adolescent behavior problems. The findings of this study how different forms of child maltreatment significantly shape behavioral outcomes and indicate the importance of interventions in enhancing emotional awareness and expression in adolescents with a childhood history of maltreatment.

Profiles of interpersonal relationship qualities and trajectories of internalizing problems among Chinese adolescents

Adolescence is a significant period for the formation of relationship networks and the development of internalizing problems. With a sample of Chinese adolescents (N = 3,834, 52.01% girls, Mage = 16.68 at Wave 1), the present study aimed to identify the configuration of adolescents' relationship qualities from four important domains (i.e., relationship quality with mother, father, peers, and teachers) and how distinct profiles were associated with the development of internalizing problems (indicated by depressive and anxiety symptoms) across high school years. Latent profile analysis identified a five-profile configuration with four convergent profiles (i.e., relationship qualities with others were generally good or bad) and one "Father estrangement" profile (i.e., the relationship quality with others were relatively good but that with father was particularly poor). Further conditional latent growth curve analysis indicated the "Father estrangement" profile was especially vulnerable to an increase in the internalizing problems as compared with other relationship profiles. This study contributes to understanding the characteristics of interpersonal relationship qualities and their influences on adolescent internalizing problems in a non-Western context. Results were further discussed from a culturally specific perspective.

Promoting Physical and Mental Health among Children and Adolescents via Gamification-A Conceptual Systematic Review

The rapid growth in digital technology usage among children and adolescents has highlighted the need for novel approaches to promote their physical and mental health. This paper investigates the viability of gamification-the application of game mechanics to non-gaming contexts-as a potent instrument for health promotion and mental health support. This conceptual systematic review seeks to examine the various published articles promoting children and adolescents' physical and mental health through gamified techniques. These interventions can provide an interactive and engaging platform for encouraging physical activity, promoting healthy nutrition, enhancing emotional regulation, and promoting mental health. The significance of this topic stems from the pervasive use of electronic games, beginning at a young age, which makes them popular educational tools. For the review to be systematic and reproducible, the PsycINFO, Scopus, PubMed, and Elsevier databases were searched and the PRISMA method was utilized for the analysis. After analyzing the research data, empirical studies assessing the use of gamification in promoting adolescents' physical and mental health are discussed. In conclusion, gamification has demonstrated promise for promoting children's and adolescents' physical and mental health. It improves motivation, commitment, and adherence to healthy behaviors. However, additional research is required to evaluate gamification interventions' long-term effectiveness and sustainability in promoting health behaviors among this population.

Role of Pubertal Timing and Perceived Parental Attachment in Internalizing Problem Behaviours Among Adolescents

Adolescents need supportive social institutions to help them deal effectively with the demands of pubertal changes accompanied by new social roles, reducing their susceptibility to problem behaviors. Considering this, it will be investigated how internalizing problem behaviors in teenagers is affected by the interaction between pubertal timing and perceived parental attachment. For this, cross-sectional data from 772 adolescents with ages ranging from 11 to 15 years old was used. Regression analyses showed early maturing adolescents with insecure perceived parental attachments had higher levels of depression and anxiety than their early, on-time, and late maturing counterparts with secure perceived parental attachments. This finding supports the contextual amplification model, as the detrimental consequences of early maturation are impacted by difficult parent-adolescent relationships.

Mental Health During Early Adolescence and Later Cardiometabolic Risk: A Prospective Study of US Latinx Youth

PURPOSE

Rising rates of cardiometabolic risk and mental health problems are serious public health concerns for US adolescents, particularly those of Latinx origin. This research examines how Latinx youth's internalizing symptoms during early adolescence are related to sleep problems, overweight/obesity, sedentary behavior, physical activity, healthy diet, and hypertension or diabetes risk during middle and late adolescence.

METHODS

Participants included 547 adolescents listed as "Hispanic" on 2017-18 middle school enrollment lists in a suburban Atlanta, GA school district. Survey data collected at baseline (2018) and four years later (2022) were analyzed using Structural Equation Model. Path estimates from baseline internalizing symptoms to later health behaviors and physical health outcomes adjusted for demographics, the follow-up measure of internalizing symptoms, and correlations among outcome variables. Missing data were handled using Full Information Maximum Likelihood.

RESULTS

At baseline, the 244 (44.6%) male and 303 (55.4%) female participants had a mean (standard deviation) age in years of 13.31 (0.97). Early adolescent internalizing symptoms were associated positively with later sleep problems (ß = 0.36 [95% confidence interval (CI), 0.24-0.48]), overweight/obesity (adjusted odds ratio, 2.57; 95% CI, 1.29-5.15), sedentary behavior (ß = 0.19 [95% CI, 0.09-0.30]), and internalizing symptoms (ß = 0.48 [95% CI, 0.39-0.56]) and inversely with later physical activity (ß = -0.16 [95% CI, -0.27 to -0.05]) and a healthy diet (ß = -0.21 [95% CI, -0.32 to -0.09]).

DISCUSSION

Latinx youth's internalizing symptoms during early adolescence not only track into later adolescence, but they also relate to health behaviors and outcomes underlying cardiometabolic risk during middle and late adolescence.

The Impact of Parental Mental Health Diagnoses, Trauma, and Coping Mechanisms on Their Children's Well-Being

The transgenerational effects of parental diagnoses, trauma and coping mechanisms on children's internalizing symptoms are not well understood. In a population-based study of 933 families combining data from a web-based survey and the Danish registers, we used an online survey of parents to examine how parental diagnoses, trauma and coping mechanisms affect the development of internalizing symptoms in children aged 6 to 18 years. To account for attrition, we used inverse probability weights in our regression models. Children of parents diagnosed with depression or anxiety displayed more internalizing symptoms than children of controls. Similarly, children of parents who experienced multiple trauma had significantly more internalizing symptoms. In contrast, we observed significantly fewer internalizing symptoms among children of parents who felt they could cope well. The protective effect of parental coping persisted even after adjusting for parental diagnoses or trauma. Interventions boosting parental coping mechanisms might help to prevent the development of internalizing symptoms in children even among patients who have been diagnosed with depression or anxiety or experienced a high trauma load.

The Youth Internalizing Problems Screener: Validation in Serbian Adolescents and Measurement Invariance across Serbia and the USA

The Youth Internalizing Problems Screener (YIPS) is a recently developed measure of general internalizing problems in adolescence. Validity evidence supporting interpretation and use of the YIPS outside the USA is still limited, and no research to date has examined cross-national invariance of this scale. Using two samples of Serbian adolescents, the present study examined the factor structure, internal consistency reliability, and convergent and incremental validity of a Serbian language version of the YIPS. Following, we evaluated the measurement invariance of the YIPS across Serbian and USA samples. Evidence for a one-factor structure and good internal consistency for the Serbian YIPS was found. The scale scores yielded strong associations with measures of depression, anxiety, life satisfaction, and positive and negative affect, indicating evidence of convergent validity. YIPS scores also had a unique contribution over and above depression and anxiety in predicting subjective well-being, thus supporting incremental validity. Partial scalar invariance for the YIPS measurement model was indicated across Serbian and USA samples. We conclude the YIPS appears to be a psychometrically sound measure of general internalizing problems among Serbian adolescents.

Longitudinal Associations from Maternal and Paternal Internalizing Symptoms to Preschooler's Problem Behavior and Social Competence in China: The Mediating Role of Executive Function

By using a two-year longitudinal design, the current study recruited 199 preschoolers and their parents in Beijing to examine the effects of parental internalizing symptoms (T1) on children's internalizing and externalizing problem behavior and social competence (T3), and further explore whether executive function (EF, T2) may act as the mediator. The results showed that maternal internalizing symptoms and paternal internalizing symptoms at T1 separately had significant direct predictive effect on children's internalizing and externalizing problem behavior but not on social competence at T3 after controlling family socioeconomic status. Further analysis indicated that children's inhibitory self-control at T2 mediated the association between maternal and paternal internalizing symptoms at T1 and children's externalizing problem behavior at T3, and metacognition at T2 could mediate the influence of maternal internalizing symptoms at T1 on children's internalizing problem behavior, externalizing problem behavior and social competence at T3. These findings to some extent highlight the importance of including both parents and exploring mother-father differences in effective interventions aiming to promoting child development. Metacognition and self-control skill training would be helpful to reduce children's problem behavior or to improve their social competence.

Ecological-Systems Contributors to Internalizing Symptoms in a US Sample of Adolescents During the COVID-19 Pandemic

OBJECTIVE

Internalizing problems are common in adolescence and increased substantially during the COVID-19 pandemic. Although rates of anxiety and depression have since improved, the general increase in the prevalence of mental health problems and disruptions to mental health services during the COVID-19 pandemic has resulted in huge gaps in care. Although research has primarily focused on proximal correlates of internalizing problems, a growing literature suggests that factors outside youths' immediate microsystems are equally crucial for their mental well-being. Thus, it is important to investigate multisystemic correlates of internalizing problems to inform individual and community-based interventions to address the current mental health burden.

METHOD

Leveraging secondary data from a nationally diverse U.S. sample of 2,954 adolescents (ages 13-16), we examined the associations between factors at multiple levels of youths' ecologies - spanning indicators of threat and deprivation - and their depression and anxiety symptoms during the COVID-19 pandemic. Furthermore, in follow-up exploratory analyses, we examined if these associations differed by adolescents' racial/ethnic groups.

RESULTS

Consistent with socioecological models, we found that indicators of threat and deprivation in the adolescents' immediate home and more distal neighborhood environments were associated with depression and anxiety symptoms. The patterns of associations were similar across racial/ethnic groups in multigroup structural equation models. Additionally, we found that mean levels of internalizing symptoms and socioecological predictors significantly differed across racial/ethnic groups.

CONCLUSION

These findings have important implications for understanding multi-level contributors to adolescent mental health, which may inform research, practice, and policy.

Longitudinal Relations Between Emotion Regulation and Internalizing Symptoms in Emerging Adults During the Covid-19 Pandemic

Background

Maladaptive and adaptive emotion regulation are putative risk and protective factors for depression and anxiety, but most prior research does not differentiate within-person effects from between-person individual differences. The current study does so during the early part of the Covid-19 pandemic when internalizing symptoms were high.

Methods

A sample of emerging adult undergraduate students (N = 154) completed online questionnaires bi-weekly on depression, anxiety, and emotion regulation across eight weeks during the early days of the Covid-19 pandemic (April 2nd to June 27th, 2020).

Results

Depression demonstrated significantly positive between-person correlations with overall maladaptive emotion regulation, catastrophizing, and self-blame, and negative correlations with overall adaptive emotion regulation and reappraisal. Anxiety demonstrated significantly positive between-person correlations with overall maladaptive emotion regulation, rumination, and catastrophizing, and a negative correlation with reappraisal. After controlling for these between-person associations, however, there were generally no within-person associations between emotion regulation and internalizing symptoms.

Conclusions

Emotion regulation and internalizing symptoms might be temporally stable individual differences that cooccur with one another as opposed to having a more dynamic relation. Alternatively, these dynamic mechanisms might operate over much shorter or longer periods compared to the two-week time lag in the current study.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10608-023-10366-9.

A test of differential susceptibility in behavior trajectories of preterm infants from preschool to adulthood

Preterm birth predisposes children to internalizing and externalizing behaviors that may persist into adolescence resulting in adult mental health conditions. Social and caregiving contexts, particularly for vulnerable infants born preterm, influence long-term outcomes, but mechanisms are not clearly understood. Healthcare teams caring for those born preterm face difficulty predicting who will be most affected by risk, who will most benefit, and the optimal timing of intervention. Differential susceptibility theory offers an alternative to the traditional risk-only assessments and theories by positing that individuals may be more, or less, susceptible to environmental influences. A sample of preterm- and term-born infants were followed from birth to 23 years of age. Mixed model repeated measures analyses of internalizing and externalizing behaviors were utilized for the comparison groups (N = 214; observations = 1070). Environmental contexts were indexed as proximal protection (low, moderate, high) and medical risk (low, moderate, high). Personal characteristic covariates of sex, race, socioeconomic status, and cognition were modeled. Internalizing behavior trajectories varied significantly over time. Early proximal protective environments conferred a sustained positive influence on behaviors. There is partial support for differential susceptibility theory suggesting that prematurity, as a malleability characteristic enables absorption of both the positive and negative influences of the environment, with greater intensity that those without malleability. The current analyses suggest lasting effects of the preschool age proximal environment on internalizing and externalizing behaviors in young adulthood for those born preterm. Understanding these nuances may aid healthcare professionals in the promotion and timing of interventions to support the child and family. The current manuscript reflects ongoing analyses of longitudinal data. No patient or public contribution to the analyses were required for testing the differential susceptibility theory. The authors would solicit patient or public contribution when implementing practice or policy changes based on the results.

Negative Emotionality and Internalizing Behaviors in Preschool Children: Moderating Role of Inhibitory Control

Negative emotionality in childhood is typically positively associated with internalizing behaviors, whereas inhibitory control is negatively associated with internalizing behaviors. Recent work, however, has also found that inhibitory control paradoxically increases risk for internalizing behaviors in the context of some reactive temperamental styles. The purpose of the present study was to examine whether inhibitory control moderated the association between negative emotionality and prospective internalizing behaviors in typically developing preschoolers (N = 104, 51 girls, M_age = 3.46 years, SD_age = 0.19). We found that negative emotionality at T1 was only positively associated with internalizing behaviors at T2 in preschoolers with relatively higher inhibitory control. Our results suggest that relatively high levels of inhibitory control may be less adaptive for children who also have relatively high levels of negative emotionality. Findings are discussed in the context of cognitive overcontrol in understanding risk for internalizing behaviors before formal school entry.

Efficacy of a peer-based in-home education program in improving social-emotional outcomes of parents and children

Significant disparities in education and social-emotional outcomes exist between racial/ethnic groups, particularly impacting children growing up in impoverished environments. Home visitation intervention programs, such as the Home Instruction for Parents of Preschool Youngsters (HIPPY), have been used for decades to improve academic readiness in these vulnerable preschool-aged children. Although the benefits of HIPPY on academic readiness and performance are well-documented, there has been no examination of social-emotional benefits to participating parent-child dyads. This study followed a HIPPY cohort over the course of 1 year to evaluate change in maternal and child social-emotional and behavioral functioning. Program participants demonstrated reduced parental stress and depression and increased parental social connection as well as reduced child externalizing behaviors and improved child adaptive functioning over the course of the program, even in the context of the COVID-19 pandemic and associated lockdown. These data highlight the additional benefits of early home-based academic intervention programs.

Which mother-headed households' parenting styles are related to children's behavior problems? A cross-sectional study

Introduction

Parenting styles are considered as one of the main determinants of individual and social behaviors and the use of dysfunctional styles can create child behavioral problems. The aim of this study was to determine the relationship between mother-child relationship patterns in mother-headed households and children's behavioral problems.

Methods

This is a descriptive-analytical cross-sectional study that was performed on 345 mother-headed households under the coverage of the Imam Khomeini Relief Committee in Shiraz, Iran. Mothers were selected by convenience sampling method and data were collected using several questionnaires including the mother-child relationship evaluation, the child behavior checklist, and social support appraisals scale. Data were analyzed using SPSS software version 21.

Results

The overprotective parenting style, as one of the inefficient models has been used more than others by mother-headed households as well as the mothers with higher education levels used less from the child-rearing style " excessive ease ", and benefited more from the support of friends and others. In addition, children of divorced and low-income mothers are more prone to externalizing behavioral problems. The final result was also determined two parenting styles "excessive ease and overprotection" are effective on children's total behavioral problems.

Conclusion

The findings highlight the need to plan and expand socio-economic and educational support services to improve living conditions and parenting skills in mother-headed households. Further research is also suggested to identify the determinants and types of interventions affecting mother-child relationships, children's behavioral problems, and finally quality of life among this low-income and vulnerable group.

Internalizing Behavior Problems Among the Left-Behind Children of the Hui Nationality in Rural China: A Cross-Sectional Study

Background

The internalizing behavior problems (IBPs) of left-behind children (LBC) due to parental migration are a widespread public health concern in China. A previous study showed that the detection rate of behavioral problems in the Hui was far higher than in the LBC of the Han nationality. However, to date, limited research has focused on IBPs in Chinese LBC of the Hui nationality. The aims of this present study are to explore the prevalence of IBPs and the influencing factors among the Hui LBC in the rural areas of China.

Methods

A cross-sectional study was conducted among school students from the southern rural areas in Ningxia, China (2012–2013). The caregivers or parents assessed IBPs using Achenbach’s Child Behavior Checklist for parents. The children completed the Egma Minnen av Bardndosnauppforstran, Junior Eysenck Personality Questionnaire and Piers–Harris Children’s Self-concept Scale. Data on 383 Hui LBC aged 6–16 y were included in this study. Multivariate logistic regression analysis was used to examine the relationships between the independent variables and children’s internalizing behaviors.

Results

Among the Hui population, the prevalence of IBPs in LBC and non-left-behind children (non-LBC) was 21.67% (83 of 383) and 18.18% (104 of 572), respectively, with no significant difference between these two groups (χ² = 1.77 and P = 0.18). However, among males of the Hui population, the prevalence of IBPs in LBC was 22.16%, which is significantly higher than in non-LBC (14.07%; χ² = 5.07; and P = 0.02). By controlling for gender and age, the multivariate logistic regression analysis showed that a mother highly favoring the subject (odds ratio [OR] = 2.70), average levels of neuroticism (OR = 9.01), and high levels of neuroticism (OR = 8.44) were risk factors for IBPs in Hui LBC.

Conclusion

Our findings suggest that IBPs among male LBC of the Hui nationality in rural China were positively related to parental migration. Positive measures should be taken to prevent IBPs of male LBC of the Hui nationality in rural China in terms of personality development and parental childrearing patterns.

Internalizing Symptoms Among Youth in Foster Care: Prevalence and Associations with Exposure to Maltreatment

Among youth in foster care (N = 303, aged 11-17 years), we investigated prevalence of internalizing symptoms; associations between symptom level and maltreatment types and numbers; and the interaction between gender and maltreatment, on internalizing symptoms. Youth completed Spence Children Anxiety Scale, Short Mood Feelings Questionnaire, and Child and Adolescent Trauma Screen. Compared to community samples, symptom levels above clinical cut-off was more frequent, with social- and generalized anxiety (ES = 0.78-0.88) being most prevalent among youth in foster care. Girls reported more internalizing symptoms (ES = 0.59-0.93). Sexual abuse and neglect were associated with a broader range of internalizing symptoms (ES = 0.35-0.64). Increased incidence of maltreatment was associated with increased levels of symptoms (ES = 0.21-0.22). Associations between maltreatment and symptom level were stronger for girls. This study stresses the importance of broad screening of maltreatment and internalizing symptoms to meet the needs of youth in foster care.

Attachment security predicts adolescents' prosocial and health protective responses to the COVID-19 pandemic

Prosocial and health protective behaviors are critical to contain the COVID-19 pandemic, yet adolescents have been difficult to engage. Attachment security promotes adolescents' capacities to navigate stress, and influences prosocial and health behaviors. Drawing on a diverse sample of 202 adolescents (48% female; 47.5% Latinx) this study evaluated relations among attachment, mental health, and prosocial and health protective responses to the COVID-19 pandemic. Attachment security (age 12) predicted adolescents' (age 15) COVID-19 prosocial (f2  = .201) and health protective behaviors (f2  = .274) during the pandemic via smaller-than-expected increases in mental health symptoms above pre-pandemic levels (age 14). Findings highlight the importance of attachment for supporting adolescents' mental health responses to life stressors and promoting prosocial and health protective behaviors.

The effects of mental health problems in childhood and adolescence in young adults: Results of the KiGGS cohort

Mental health problems in childhood and adolescence may have effects into adulthood. With the KiGGS cohort, data are available for the first time that can be used to track the effects of internalising and externalising problems in childhood or adolescence into young adulthood on a national database. From the KiGGS baseline survey (2003-2006) to KiGGS Wave 2 (2014-2017), a total of 3,546 children and adolescents aged 11 to 17 years were tracked over a period of eleven years into young adulthood. Mental health problems in childhood or adolescence were variously associated with impaired mental health, lower life satisfaction and poorer quality of life and indicators of sexual and reproductive health in young adulthood. When psychosocial protective factors at the time of the KiGGS baseline survey were considered, the longitudinal correlations of internalising and externalising problems with indicators of mental health, life satisfaction and physical and psychological quality of life decreased, as did, to a lesser extent, the correlations with indicators of sexual and reproductive health and, for externalising disorders, also with low educational status (reference: medium). Implications for prevention and intervention are discussed.

Neural connectivity biotypes: associations with internalizing problems throughout adolescence

BACKGROUND

Neurophysiological patterns may distinguish which youth are at risk for the well-documented increase in internalizing symptoms during adolescence. Adolescents with internalizing problems exhibit altered resting-state functional connectivity (RSFC) of brain regions involved in socio-affective processing. Whether connectivity-based biotypes differentiate adolescents' levels of internalizing problems remains unknown.

METHOD

Sixty-eight adolescents (37 females) reported on their internalizing problems at ages 14, 16, and 18 years. A resting-state functional neuroimaging scan was collected at age 16. Time-series data of 15 internalizing-relevant brain regions were entered into the Subgroup-Group Iterative Multi-Model Estimation program to identify subgroups based on RSFC maps. Associations between internalizing problems and connectivity-based biotypes were tested with regression analyses.

RESULTS

Two connectivity-based biotypes were found: a Diffusely-connected biotype (N = 46), with long-range fronto-parietal paths, and a Hyper-connected biotype (N = 22), with paths between subcortical and medial frontal areas (e.g. affective and default-mode network regions). Higher levels of past (age 14) internalizing problems predicted a greater likelihood of belonging to the Hyper-connected biotype at age 16. The Hyper-connected biotype showed higher levels of concurrent problems (age 16) and future (age 18) internalizing problems.

CONCLUSIONS

Differential patterns of RSFC among socio-affective brain regions were predicted by earlier internalizing problems and predicted future internalizing problems in adolescence. Measuring connectivity-based biotypes in adolescence may offer insight into which youth face an elevated risk for internalizing disorders during this critical developmental period.

Childhood residential mobility and health outcomes: A meta-analysis

This study assesses the association between childhood residential mobility and health-related outcomes by way of a meta-analysis of studies published between 1989 and 2020. The sample includes 844 effect sizes from 64 unique studies. The results point to a negative association (small to medium) between childhood mobility and health. This association is contingent upon the type of health outcome studied, age at outcome assessment, age at moving, and frequency of moves. The major confounders of this association are parental SES, parental marital status, ethnicity, and co-occurring childhood adversities. The implications for future research are discussed.

Health Literacy and Health Behavior: Associated Factors in Surabaya High School Students, Indonesia

(1) Background: The health behavior (HB) of adolescents develops in the school or family setting and plays an important role in their future health status. Health literacy (HL) has been identified as an important factor in modifying health behavior in addition to socioeconomic factors. health-promoting school (HPS) programs also have a significant role in providing students with the means of learning the importance of knowledge, behavior, and skills for a healthy lifestyle. (2) Method: This study aims to identify the association between HB, HL measured in comprehensive health literacy (CHL) and functional health literacy (FHL), HPS programs, and socioeconomic factors among high school students in Surabaya, Indonesia. A cross-sectional study was conducted, and 1066 students were evaluated as respondents. (3) Result: The results of multivariate analyses showed that following factors were associated with better health behavior: female, better academic performance, higher grade, higher father’s education, lower allowance, and better CHL and FHL. The strongest association for HB was gender. CHL was especially associated with handwashing, physical activity, and drug abuse. FHL was associated with smoking and drug abuse. The implementation of HPS programs did not reach an optimum level and only influenced physical activity. (4) Conclusions: The findings confirm that CHL and FHL have a significant association with several HBs. HB intervention in the HPS program is recommended to incorporate the CHL and FHL for a better health impact.

The Relationship Between Family Functioning and Internalizing Problems in Chinese Adolescents: A Moderated Mediation Model

Research has consistently found that poor family functioning is a risk factor for adolescents' internalizing problems. However, studies of the mediating and moderating mechanisms underlying this relation are insufficient. In this study, we explore the association between family functioning and adolescents' internalizing problems by testing the mediating roles of positive youth development (PYD) attributes and the moderating role of migrant status. A large cross-sectional sample of 11,865 Chinese adolescents (mean age = 14.45 years, standard deviation = 1.55 years) were used to measure internalizing problems, family functioning, PYD, migrant status, and other demographic information. After controlling for covariates (age, gender, grade, and socioeconomic status), the results revealed that PYD mediated the relation between family functioning and internalizing problems. Moreover, migrant status moderated the relationship between family functioning and internalizing problems. Specifically, the effects of family functioning on internalizing problems were stronger among local-born adolescents than among migrant adolescents. The findings indicate that improving family functioning and PYD attributes may be promising approaches to prevent/reduce adolescent internalizing problems.

What's in a diagnosis: The effect of externalizing and internalizing students' behaviour on pre-service teachers' classroom management and interaction strategies

BACKGROUND

All over the word, classrooms are getting more and more diverse and teachers are required to effectively manage these classes even when students have special education needs (SEN).

AIMS

The study aimed to investigate classroom management strategies and interpersonal teacher behaviour in relation to students internalizing and externalizing behaviour, whereby we varied the diagnosis of special educational needs.

SAMPLE

Two hundred and fifty-four German pre-service teachers (143 female) with a mean age of 26.04 years participated in the study.

METHOD

Using an experimental between-subjects design, a fictitious student was described as exhibiting either internalizing or externalizing behaviour. Additionally, we varied whether the student was diagnosed as having SEN or not. The participants were asked to indicate which strategies they would apply and how they would interact with students.

RESULTS

Results showed that teacher interaction in response to both students with internalizing and externalizing behaviour approached ideal interpersonal teacher behaviour (i.e. high level of cooperativeness with certain level of dominance), whereas pre-service teachers applied all classroom management strategies to minimize effects of student behaviour on learning time. Although pre-service teachers adapted their responses based on type of behaviour, they only made allowances for internalizing behaviour while their response to externalizing behaviour did not vary much as a function of a SEN diagnosis.

CONCLUSIONS

Together, these findings highlight the importance of providing pre-service teachers with the pedagogical knowledge concerning effective classroom management and flexible use of strategies in response to diverse student needs in inclusive classrooms.

Higher Executive Control Network Coherence Buffers Against Puberty-Related Increases in Internalizing Symptoms During the COVID-19 Pandemic

BACKGROUND

Early pubertal maturation has been posited to be a biopsychosocial risk factor for the onset of internalizing psychopathology in adolescence; further, early-maturing youths exhibit heightened reactivity to stressful events. School closures and enforced social distancing, as well as health and financial uncertainties, during the COVID-19 pandemic are expected to adversely affect mental health in youths, particularly adolescents who are already at risk for experiencing emotional difficulties. The executive control network (ECN) supports cognitive processes required to successfully navigate novel challenges and regulate emotions in stressful contexts.

METHODS

We examined whether functional coherence of the ECN, measured using resting-state functional magnetic resonance imaging 5 years before the pandemic (T1), is a neurobiological marker of resilience to increases in the severity of internalizing symptoms during COVID-19 in adolescents who were in more advanced stages of puberty at T1 relative to their same-age peers (N = 85, 49 female).

RESULTS

On average, participants reported an increase in symptoms from the 3 months before pandemic to the 2 most recent weeks during the pandemic. We found that early-maturing youths exhibited greater increases in internalizing symptoms during the pandemic if their ECN coherence was low; in contrast, relative pubertal stage was not associated with changes in internalizing symptoms in adolescents with higher ECN coherence at T1.

CONCLUSIONS

These findings highlight the role of the functional architecture of the brain that supports executive functioning in protecting against risk factors that may exacerbate symptoms of internalizing psychopathology during periods of stress and uncertainty.

Parental socioeconomic status, adolescents' screen time and sports participation through externalizing and internalizing characteristics

The socioeconomic status of parents is reportedly closely related to the digital screen usage and physical inactivity levels of children and adolescents. Internalizing and externalizing behavior characteristics may be linked to these associations and explain them. The purpose of the present study was to investigate the effects of parents' socioeconomic status (SES) on youths' total screen time along with physical inactivity through internalizing and externalizing behavior characteristics. Thus, we examined associations between parents' socioeconomic status (using scores based on several indicators) and adolescents' total digital screen exposure and physical inactivity level, together with the potentially predicting role of the adolescents' internalizing and externalizing behavior. For this, we assessed the internalizing and externalizing problem characteristics, total screen time exposure, physical inactivity level and parental socioeconomic status of a large cohort sample of Finnish adolescents (the Northern Birth Cohort, 1986 comprised 2899 males and 3059 females). The present study includes data collected in two phases, in 1985–1986 and 2000–2001. Path modeling suggests that a low SES of parents was directly associated with adolescents' physical inactivity level, while externalizing characteristics were a significant and additional contributing factor in adolescents' level of screen exposure in both genders. Gender moderated the relationship between adolescents' internalizing and externalizing characteristics and physical inactivity levels. The results also suggest that parents’ socioeconomic status constitutes a risk factor in relation to media screen exposure only in female adolescents. Implications of the findings are discussed.

The Southern Illinois Twins/Triplets and Siblings Study (SITSS): A Longitudinal Study of Early Child Development

This article reviews the Southern Illinois Twins/Triplets and Siblings Study (SITSS) and describes some of the findings related to recent projects that were completed using this sample. At this time, the SITSS has enrolled 375 twin pairs, 12 triplet families, 1 family of quadruplets, 98 nontwin sibling pairs and 287 singletons. Testing begins for twins and triplets as young as age 1 and then occurs yearly on their birthdays until 5 years of age. Through age 20, various follow-up studies have been conducted on the SITSS sample to examine their social, emotional, and cognitive development across childhood and adolescence from a behavioral genetic perspective. A variety of methodologies have been used to investigate gene-environment correlations (rGE) and gene-environment interactions (GxE). Advanced statistical procedures (e.g., genetic likelihood indices and multilevel modeling) have been utilized to further investigate genetic underpinnings of behavior. Recent results have indicated genetic influences on the aggressiveness of preschoolers' media preferences, increased problem behaviors related to young children's overestimation of self-competence, and the influence of early life temperament and internalizing problems on adolescent health behaviors. Additionally, the SITSS has provided evidence for evocative rGE for various behaviors (aggression, prosocial and play), as well as findings supporting interactions between the dopamine receptor D4 gene (DRD4) and the environment (peer victimization, prenatal birth complications and parental sensitivity). Together, by use of multitrait and multimethodological investigations, this behavior genetic data set assists in furthering our understanding of biological and environmental influences on children's development.