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Developmental models of borderline personality disorder (BPD) emphasize the effects of youths’ biological vulnerabilities and their experiences of parental responses to emotion, as well as the interaction between these two elements. The current study evaluated the independent and interactive effects of two indices of autonomic nervous system response and parental responses to youth negative emotions on severity and exacerbation of youths’ BPD features during the transition to adolescence. The sample consisted of 162 psychiatric youth (10–14 years; 47.2% female) and their parents. At baseline, youth and their parents completed a lab-based conflict discussion during which parasympathetic and sympathetic nervous system response were measured and indices of sympathetic-parasympathetic balance and coactivation/coinhibition were calculated. Youth also reported on supportive and non-supportive parental responses. At baseline and after 9 months, youth self-reported on their BPD features. Results demonstrated that shifting toward sympathetic dominance independently predicted exacerbation of BPD across 9 months. Additionally, fewer experiences of supportive parental responses and more non-supportive parental responses were associated with greater severity of BPD features in youth. This study highlights the role of autonomic response to parent-child conflict as well as the significance of parental responses to youth emotion for the development of BPD during this developmental window.
To examine: (1) cross-sectional and longitudinal associations between measures of food insecurity (FI; household status and youth-reported) and intuitive eating (IE) from adolescence to emerging adulthood; and (2) the association between FI persistence and IE in emerging adulthood.
Longitudinal population-based study. Young people reported IE and FI (two items from the U.S. Household Food Security Module) in adolescence and emerging adulthood. Parents provided data on household FI via the six-item U.S. Household Food Security Module in adolescence.
Adolescents (Mage=14.3±2 years) and their parents, recruited from Minneapolis/St. Paul public schools in 2009-2010 and again in 2017-2018 as emerging adults (Mage=22.1±2 years).
The analytic sample (N=1,372; 53.1% female, 46.9% male) was diverse across race/ethnicity (19.8% Asian, 28.5% Black, 16.6% Latinx, 14.7% Multiracial/Other, and 19.9% White) and SES (58.6% low/lower middle, 16.8% middle, 21.0% upper middle/high).
In cross-sectional analyses, youth-reported FI was associated with lower IE during adolescence (p=.02) and emerging adulthood (p<.001). Longitudinally, household FI, but not adolescent experience of FI, was associated with lower IE in emerging adulthood (p=.01). Those who remained food insecure (p=.05) or became food insecure (p=.02) had lower IE in emerging adulthood than those remaining food secure. All effect sizes were small.
Results suggest FI may exert immediate and potentially lasting impacts on IE. As evidence suggests IE is an adaptive approach conferring benefits beyond eating, it would be valuable for interventions to address social and structural barriers that could impede IE.
Recent theoretical models have posited that increases in self-injurious thoughts and behaviors (SITBs) during adolescence may be linked to failures in biological stress regulation in contexts of social stress. However, there is a lack of data examining this hypothesis during the transition to adolescence, a sensitive period of development characterized by changes across socioaffective and psychophysiological domains. Building on principles from developmental psychopathology and the RDoC framework, the present study used a longitudinal design in a sample of 147 adolescents to test whether interactions among experiences of social (i.e., parent and peer) conflict and cardiac arousal (i.e., resting heart rate) predicted adolescents’ engagement in SITBs (i.e., nonsuicidal self-injury, NSSI; and suicidal ideation; SI) across 1-year follow-up. Prospective analyses revealed that adolescents experiencing a combination of greater peer, but not family, conflict and higher cardiac arousal at baseline showed significant longitudinal increases in NSSI. In contrast, social conflict did not interact with cardiac arousal to predict future SI. Findings indicate that greater peer-related interpersonal stress in adolescents may increase risk for future NSSI among youth with physiological vulnerabilities (i.e., higher resting heart rate) that may be markers of maladaptive stress responses. Future research should examine these processes at finer timescales to elucidate whether these factors are proximal predictors of within-day SITBs.
In recent years, there have been extensive efforts in secondary schools to prevent, treat and raise awareness of adolescent mental health problems. For some adolescents, these efforts are essential and will lead to a reduction in clinical symptoms. However, it is also vital to assess whether, for others, the current approach might be causing iatrogenic harm. A growing body of quantitative research indicates that some aspects of school-based mental health interventions increase distress or clinical symptoms, relative to control activities, and qualitative work indicates that this may be partly due to the interventions themselves.
Internalizing and externalizing problems that emerge during adolescence differentially increase boys’ and girls’ risk for developing psychiatric disorders. It is not clear, however, whether there are sex differences in the intrinsic functional architecture of the brain that underlie changes in the severity of internalizing and externalizing problems in adolescents. Using resting-state fMRI data and self-reports of behavioral problems obtained from 128 adolescents (73 females; 9–14 years old) at two timepoints, we conducted multivoxel pattern analysis to identify resting-state functional connectivity markers at baseline that predict changes in the severity of internalizing and externalizing problems in boys and girls 2 years later. We found sex-differentiated involvement of the default mode network in changes in internalizing and externalizing problems. Whereas changes in internalizing problems were associated with the dorsal medial subsystem in boys and with the medial temporal subsystem in girls, changes in externalizing problems were predicted by hyperconnectivity between core nodes of the DMN and frontoparietal network in boys and hypoconnectivity between the DMN and affective networks in girls. Our results suggest that different neural mechanisms predict changes in internalizing and externalizing problems in adolescent boys and girls and offer insights concerning mechanisms that underlie sex differences in the expression of psychopathology in adolescence.
Penalties are used in an effort to curtail drug use by citizens in most societies. There are growing calls for a reduction or elimination of such penalties. Deterrence theory suggests that use should increase if penalties reduce and vice versa. We sought to examine the relationship between changes to penalties for drug possession and adolescent cannabis use.
Ten instances of penalty change occurred in Europe between 2000 and 2014, seven of which involved penalty reduction and three involved penalty increase. We conducted a secondary analysis of a series of cross-sectional surveys of 15–16-year-old school children, the ESPAD surveys, which are conducted every four years. We focused on past month cannabis use. We anticipated that an eight-year time span before and after each penalty change would yield two data points either side of the change. A simple trend line was fitted to the data points for each country.
In eight cases, the trend slope in past month cannabis use was in the direction predicted by deterrence theory, the two exceptions being the UK policy changes. Using the principals of binomial distributions, the likelihood of this happening by chance is 56/1024 = 0.05. The median change in the baseline prevalence rate was by 21%.
The science seems far from settled on this issue. There remains a distinct possibility that reducing penalties could contribute to small increases in adolescent cannabis use and consequently increase cannabis-related harms. This possibility should be considered in any political decision-making influencing drug policy changes.
Cannabis use has been linked to poorer episodic memory. However, little is known about whether depression and sex may interact as potential moderators of this association, particularly among adolescents. The current study addresses this by examining interactions between depression symptoms and sex on the association between cannabis use and episodic memory in a large sample of adolescents.
Cross-sectional data from 360 adolescents (Mage = 17.38, SD = .75) were analyzed at the final assessment wave of a two-year longitudinal study. We used the Drug Use History Questionnaire to assess for lifetime cannabis use, and the Computerized Diagnostic Interview Schedule for Children, Fourth edition to assess the number of depression symptoms in the past year. Subtests from the Wechsler Memory Scale, Fourth Edition and the California Verbal Learning Test, Second Edition were used to assess episodic memory performance.
The effect of the three-way interaction among cannabis use, depression symptoms, and sex did not have a significant impact on episodic memory performance. However, follow-up analyses revealed a significant effect of the two-way interaction of cannabis use and depression symptoms on episodic memory, such that associations between cannabis use and episodic memory were only significant at lower and average levels of depression symptoms.
Contrary to our hypotheses, we found that as depression symptoms increased, the negative association between cannabis use and episodic memory diminished. Given the use of a predominantly subsyndromic sample, future studies should attempt to replicate findings among individuals with more severe depression.
According to environmental sensitivity models, children vary in responsivity to parenting. However, different models propose different patterns, with responsivity to primarily: (1) adverse parenting (adverse sensitive); or (2) supportive parenting (vantage sensitive); or (3) to both (differentially susceptible). This preregistered study tested whether these three responsivity patterns coexist. We used intensive longitudinal data of Dutch adolescents (N = 256, Mage = 14.8, 72% female) who bi-weekly reported on adverse and supportive parenting and their psychological functioning (tmean = 17.7, tmax = 26). Dynamic Structural Equation Models (DSEM) indeed revealed differential parenting effects. As hypothesized, we found that all three responsivity patterns coexisted in our sample: 5% were adverse sensitive, 3% vantage sensitive, and 26% differentially susceptible. No adolescent appeared unsusceptible, however. Instead, we labeled 28% as unperceptive, because they did not perceive any changes in parenting and scored lower on trait environmental sensitivity than others. Furthermore, unexpected patterns emerged, with 37% responding contrary to parenting theories (e.g., decreased psychological functioning after more parental support). Sensitivity analyses with concurrent effects and parent-reported parenting were performed. Overall, findings indicate that theorized responsivity-to-parenting patterns might coexist in the population, and that there are other, previously undetected patterns that go beyond environmental sensitivity models.
This chapter presents a more fine-grained analysis of why and how DOM vulnerability may have become more prevalent in Spanish than in Hindi and Romanian at the individual level. Specifically, linking language acquisition, language attrition and diachronic language change, it addresses the question of the potential relationship between the I-language of the heritage speakers and the E-language of the first-generation immigrants, who are often the heritage speakers’ main source of input. It presents follow-up studies of DOM in Spanish-speaking bilingual children and adults and their mothers and the results are not consistent with direct transmission of DOM omission from the first to the second-generation (the heritage speakers). It is suggested that that second-generation heritage speakers, who have as much difficulty mastering the morphology of their heritage language as typical L2 learners, can also change the grammars of the parental generation and be the innovators in the Spanish variety spoken in the United States.
Early caregiving adversity (ECA) is associated with elevated psychological symptomatology. While neurobehavioral ECA research has focused on socioemotional and cognitive development, ECA may also increase risk for “low-level” sensory processing challenges. However, no prior work has compared how diverse ECA exposures differentially relate to sensory processing, or, critically, how this might influence psychological outcomes. We examined sensory processing challenges in 183 8-17-year-old youth with and without histories of institutional (orphanage) or foster caregiving, with a particular focus on sensory over-responsivity (SOR), a pattern of intensified responses to sensory stimuli that may negatively impact mental health. We further tested whether sensory processing challenges are linked to elevated internalizing and externalizing symptoms common in ECA-exposed youth. Relative to nonadopted comparison youth, both groups of ECA-exposed youth had elevated sensory processing challenges, including SOR, and also had heightened internalizing and externalizing symptoms. Additionally, we found significant indirect effects of ECA on internalizing and externalizing symptoms through both general sensory processing challenges and SOR, covarying for age and sex assigned at birth. These findings suggest multiple forms of ECA confer risk for sensory processing challenges that may contribute to mental health outcomes, and motivate continuing examination of these symptoms, with possible long-term implications for screening and treatment following ECA.
The parent-child relationship continues to be essential to optimal adolescent development despite a restructuring of the relationship in response to developmental needs. In this chapter we provide an overview of parenting research during adolescence, including global aspects of parenting (e.g., parenting styles, warmth, control) and nuances of parenting that are particularly salient during the teen years (e.g., parental monitoring of media and peers, parental socialization of race, parent-child sex communication). We then highlight the ways in which parenting adolescents varies as a function of demographic factors such as gender and race. Finally, we explore policy applications of the research on parenting adolescents and suggest a number of avenues for future research. The most consistent finding in our review of research, cutting across studies of parental control, monitoring, media monitoring, peer management, parent-child sex communication, and policy research – was the importance of the parent-adolescent relationship in enhancing the effects of positive parenting and buffering the effects of negative parenting.
We review the literature on how fathers contribute to their children’s development from early childhood to adolescence. First, we set the stage by giving a brief profile of who fathers are in the United States. Second, we summarize the theoretical and methodological approaches used to conceptualize and assess the role of fathers in caregiving. Third, we synthesize the empirical literature on the important correlates of father involvement and provide a critical analysis of the ways father involvement in caregiving is related to children’s cognitive, language, and social-emotional development. Lastly, we discuss implications to inform best practices and policies pertaining to this research and end with future directions.
Risky behaviors such as substance use, unsafe sexual interactions, aggression, and antisocial behavior are often elevated during adolescence and can serve as powerful influences on both youth adjustment and long-term mental and physical health outcomes. The various stages of adolescence, from early adolescence to emerging adulthood, present novel opportunities and challenges, often introducing new risk-taking opportunities. Underlying adolescents’ risk behaviors during this developmental period are extensive cognitive, biological, and social factors including brain development, new and renegotiated relationships, and contextual considerations such as socioeconomic status, community resources, and identity-related stress. Current interventions target risk behaviors at a variety of levels, focusing on individuals, families, schools, and communities, with many of these efforts demonstrating success with different populations. Future research and prevention efforts will continue to benefit from targeting multiple co-occurring behaviors, considering social influences of underserved groups facing disparities in risk-taking behaviors, culturally adapting interventions, and including other caregivers such as fathers.
Adolescence is an important stage for the development of emotion regulation skills, especially for adolescent girls who are at elevated risk for the development of depression and anxiety. Although some emotion regulation strategies are more effective at helping adolescents regulate negative affect on average, research indicates strategy effectiveness varies with the context in which a strategy is deployed. Yet less work has been done examining which contextual factors are associated with adolescents switching emotion regulation strategies in their daily lives. This study examined individual and contextual factors related to negative interpersonal events that are associated with strategy effectiveness, including age, emotional intensity, perceived controllability, and co-regulatory support, and their association with adolescent emotion regulation strategy switching in daily life via ecological momentary assessment. Results indicated that adolescent girls differed in the degree to which they altered their emotion regulation strategies throughout their daily lives, and that switching strategies was associated with age as well as individual and within-person differences in perceived controllability, emotional intensity, and co-regulatory support. This study provides critical proof-of-concept of the utility of emotion regulation strategy switching as a measure of regulatory flexibility and highlights regulatory processes that may hold clues to the mechanisms of developmental psychopathology.
The early stages of the COVID-19 pandemic and associated stay-at-home orders resulted in a stark reduction in daily social interactions for children and adolescents. Given that peer relationships are especially important during this developmental stage, it is crucial to understand the impact of the COVID-19 pandemic on social behavior and risk for psychopathology in children and adolescents. In a longitudinal sample (N=224) of children (7-10y) and adolescents (13-15y) assessed at three strategic time points (before the pandemic, during the initial stay-at-home order period, and six months later after the initial stay-at-home order period was lifted), we examine whether certain social factors protect against increases in stress-related psychopathology during the pandemic, controlling for pre-pandemic symptoms. Youth who reported less in-person and digital socialization, greater social isolation, and less social support had worsened psychopathology during the pandemic. Greater social isolation and decreased digital socialization during the pandemic were associated with greater risk for psychopathology after experiencing pandemic-related stressors. In addition, children, but not adolescents, who maintained some in-person socialization were less likely to develop internalizing symptoms following exposure to pandemic-related stressors. We identify social factors that promote well-being and resilience in youth during this societal event.
The COVID-19 pandemic has severely impacted the mental health of children and adolescents. Young people at risk for anorexia nervosa (AN) have been especially shown to be affected. There are no studies that have investigated the respective proportions of hospitalized children, adolescents, and young adults separately as well as of both sexes during the COVID-19 crisis.
This study is based on the administrative data of the largest German statutory health insurance. All children (0–14 years) and adolescents (15–19 years) with a discharge diagnosis of typical and atypical AN according to the International Classification of Diseases (ICD)-10 were included. Admission rates per 10,000 person-years were calculated separately by sex and age group, based on admission numbers from the 9-month interval from January to September of 2019, 2020, and 2021 and the number of insured persons per sex and age group of each year.
The entire sample comprised approximately 4.7 million children and adolescents. There was a highly significant increase of 40% (relative risk (RR): 1.4; [1.27, 1.55]; p < 0.0001) in admission rates in the female children’s and the adolescents’ group (RR:1.32; [1.24, 1.41]; p< 0.0001) between the pre-COVID-19 and peri-COVID-19 periods in 2019 and 2021, respectively. Among males, hospitalization rates significantly increased in the children (RR: 1.69; [1.09, 2.62]; p < 0.02).
Young people appear to be especially prone to develop AN during a crisis, such as with social isolation and school closures. Home-based or mobile pediatric services should be established to prevent this often chronic and disabling disorder in young patients.
This study aimed to systematically review and synthesise the available evidence on the prevalence and associations between psychotic-like experiences (PLEs) and substance use in children and adolescents aged ⩽17 years, prior to the typical age of development of prodromal symptoms of psychosis. As substance use has been associated with earlier age of psychosis onset and more severe illness, identifying risk processes in the premorbid phase of the illness may offer opportunities to prevent the development of prodromal symptoms and psychotic illness. MEDLINE, PsycINFO, and CINAHL databases were searched for chart review, case-control, cohort, twin, and cross-sectional studies. Study reporting was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist, and pooled evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Searches identified 55 studies that met inclusion criteria. Around two-in-five substance users reported PLEs [rate = 0.41, 95% confidence interval (CI) 0.32–0.51; low quality evidence], and one-in-five with PLEs reported using substances (rate = 0.19, 95% CI 0.12–0.28; moderate-to-high quality evidence). Substance users were nearly twice as likely to report PLEs than non-users [odds ratio (OR) 1.77, 95% CI 1.55–2.02; moderate quality evidence], and those with PLEs were twice as likely to use substances than those not reporting PLEs (OR 1.93, 95% CI 1.55–2.41; very low quality evidence). Younger age was associated with greater odds of PLEs in substance users compared to non-users. Young substance users may represent a subclinical at-risk group for psychosis. Developing early detection and intervention for both substance use and PLEs may reduce long-term adverse outcomes.
This study leveraged machine learning to evaluate the contribution of information from multiple developmental stages to prospective prediction of depression and anxiety in mid-adolescence.
A community sample (N = 374; 53.5% male) of children and their families completed tri-annual assessments across ages 3–15. The feature set included several important risk factors spanning psychopathology, temperament/personality, family environment, life stress, interpersonal relationships, neurocognitive, hormonal, and neural functioning, and parental psychopathology and personality. We used canonical correlation analysis (CCA) to reduce the large feature set to a lower dimensional space while preserving the longitudinal structure of the data. Ablation analysis was conducted to evaluate the relative contributions to prediction of information gathered at different developmental periods and relative to previous disorder status (i.e. age 12 depression or anxiety) and demographics (sex, race, ethnicity).
CCA components from individual waves predicted age 15 disorder status better than chance across ages 3, 6, 9, and 12 for anxiety and 9 and 12 for depression. Only the components from age 12 for depression, and ages 9 and 12 for anxiety, improved prediction over prior disorder status and demographics.
These findings suggest that screening for risk of adolescent depression can be successful as early as age 9, while screening for risk of adolescent anxiety can be successful as early as age 3. Assessing additional risk factors at age 12 for depression, and going back to age 9 for anxiety, can improve screening for risk at age 15 beyond knowing standard demographics and disorder history.
Mental disorders are one of the largest contributors to the burden of disease globally, this holds also for children and adolescents, especially in low- and middle-income countries. The prevalence and severity of these disorders are influenced by social determinants, including exposure to adversity. When occurring early in life, these latter events are referred to as adverse childhood experiences (ACEs).
In this editorial, we provide an overview of the literature on the role of ACEs as social determinants of mental health through the lenses of global mental health. While the relation between ACEs and mental health has been extensively explored, most research was centred in higher income contexts. We argue that findings from the realm of global mental health should be integrated into that of ACEs, e.g. through preventative and responsive psychosocial interventions for children, adolescents and their caregivers. The field of global mental health should also undertake active efforts to better address ACEs in its initiatives, all with the goal of reducing the burden of mental disorders among children and adolescents globally.
Peer victimization is a developmentally salient stressor that elevates adolescents’ risk for anxiety disorders. However, modifiable mechanisms that explain this link and can be targeted via therapeutic interventions remain poorly understood. Drawing from psychobiological models implicating aberrant threat sensitivity in the development and maintenance of psychopathology, the current study investigated sensitivity to peer-related social threats as a mechanism underlying the association between peer victimization and anxiety. A sample of 197 dyads of early adolescents (Mage = 12.02; 46% female) and parents/guardians (Mage = 41.46; 90% female) completed online surveys assessing peer victimization, sensitivity to potential (i.e., ambiguous) social threats, and anxiety. Controlling for potentially confounding demographic and psychosocial factors, both self- and parent-reported peer victimization were positively associated with adolescent anxiety symptoms. Additionally, there were significant indirect effects from self- and parent-reported peer victimization to anxiety via social threat sensitivity. Supplemental analyses indicated unique effects of covert, but not overt, peer victimization on social threat sensitivity and anxiety. The findings provide initial evidence that peer victimization experiences lower adolescents’ threshold for interpreting threats in ambiguous social situations, which contributes to heightened anxiety. These results implicate social threat sensitivity as a potential therapeutic target for interrupting links from peer victimization to psychological distress.