Adolescence: a central event in shaping stress reactivity

Early-life bisphenol A exposure causes neuronal pyroptosis in juvenile and adult male rats through the NF-κB/IL-1β/NLRP3/caspase-1 signaling pathway: exploration of age and dose as effective covariates using an in vivo and in silico modeling approach

Bisphenol A (BPA), a common endocrine-disrupting chemical, is found in a wide range of home plastics. Early-life BPA exposure has been linked to neurodevelopmental disorders; however, the link between neuroinflammation, pyroptosis, and the development of psychiatric disorders is rarely studied. The current study attempted to investigate the toxic effect of BPA on inflammatory and microglial activation markers, as well as behavioral responses, in the brains of male rats in a dose- and age-dependent manner. Early BPA exposure began on postnatal day (PND) 18 at dosages of 50 and 125 mg/kg/day. We started with a battery of behavioral activities, including open field, elevated plus- and Y-maze tests, performed on young PND 60 rats and adult PND 95 rats. BPA causes anxiogenic-related behaviors, as well as cognitive and memory deficits. The in vivo and in silico analyses revealed for the first time that BPA is a substantial activator of nuclear factor kappa B (NF-κB), interleukin (IL)-1β, -2, -12, cyclooxygenase-2, and the NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome, with higher beclin-1 and LC3B levels in BPA rats' PFC and hippocampus. Furthermore, BPA increased the co-localization of caspase-1 immunoreactive neurons, as well as unique neurodegenerative histopathological hallmarks. In conclusion, our results support the hypothesis that neuroinflammation and microglial activation are involved with changes in the brain after postnatal BPA exposure and that these alterations may be linked to the development of psychiatric conditions later in life. Collectively, our findings indicate that BPA triggers anxiety-like behaviors and pyroptotic death of nerve cells via the NF-κB/IL-1β/NLRP3/Caspase-1 pathway.

The stress-immune system axis: Exploring the interplay between stress and immunity

The chapter talks about how our body and mind respond to stress and how it affects our immune system. Stress reactions, especially the fight-or-flight reaction, are helpful at first but can be harmful if they last too long. Long-term stress, caused by hormones like cortisol and adrenaline, weakens the immune system and makes people more likely to get sick. Important brain chemicals like serotonin and norepinephrine help control how our immune system works. Also, the connection between our gut and brain is an important way that mental health affects how our immune system functions. Getting older and experiencing stress early in life can affect how our immune system works. Inflammation caused by stress is connected to health issues like heart disease, depression, and autoimmune diseases. There are ways to manage stress, like being mindful and having support from friends, are important for keeping your immune system healthy and lessening harm caused by stress.

Examining systemic inflammation as a pathway linking peer victimization to depressive symptoms in adolescence

BACKGROUND

Adolescents exposed to victimization are at an increased risk for a variety of adverse mental health outcomes, including depressive symptoms. Yet, the biological pathways underlying these associations remain poorly understood. Focusing on within-person processes, we examined whether low-grade systemic inflammation mediated the longitudinal associations between peer victimization and depressive symptoms in adolescence.

METHODS

207 adolescents (at baseline Mage = 12.69 years; SD = 0.49; 43.5% female) participated in a multi-wave longitudinal study, with assessments repeated every 6 months over 1.5 years. At each assessment wave, participants self-reported their peer victimization experiences and depressive symptoms. Dried blood spots were collected at each wave using a finger prick procedure to assay a key marker of low-grade systemic inflammation, interkeukin-6 (IL-6). Data were analyzed using random-intercept cross-lagged panel models.

RESULTS

The cross-lagged paths from IL-6 to depressive symptoms were significant across all models and waves (β12 = .13; β23 = .12; β34 = .08), indicating that when adolescents' levels of low-grade systemic inflammation were above their person-specific average, they reported increased levels of depressive symptoms in the subsequent months. However, no significant cross-lagged within-person associations emerged between peer victimization and either IL-6 or depressive symptoms.

CONCLUSIONS

The findings provide no evidence for the hypothesized mediating role of inflammation in the within-person associations between peer victimization and depressive symptoms. Nevertheless, they extend prior research by indicating that elevated levels of low-grade systemic inflammation predict the development of depressive symptoms in adolescence.

Resting Hypothalamic-Pituitary-Adrenal Axis Activity in Childhood Following Maltreatment: A Meta-Analysis

The experience of maltreatment in childhood is associated with poorer developmental and health outcomes. This may be explained by the capacity for maltreatment to dysregulate stress-responsive neurophysiological systems, including the hypothalamic-pituitary-adrenal (HPA) axis. This study presents the results of the first meta-analysis that examines the association between maltreatment and resting HPA-axis activity in children and the role of "third variables" in accounting for observed heterogeneity in this association. Analyses of 18 studies, including N = 2216 children, indicated that although there was no difference in resting HPA-axis activity between children who had been maltreated and those who had not (standardized mean difference [SMD] = 0.04), there was substantial heterogeneity in the association between maltreatment and HPA-axis activity across studies (I2 = 58.60%, p = 0.001). Further analyses revealed that the association between maltreatment and resting HPA-axis activity was contingent upon the source of information regarding maltreatment (B = 0.33, p = 0.002) and the degree to which maltreated and comparison groups differed in their socioeconomic status (B = 0.39, p = 0.037).

The indirect effect of sleep quality on stress-related psychosocial outcomes in adolescents: an investigation across genders

Background

Sleep is foundational for adolescent psychosocial outcomes though often compromised by normative developmental changes and external factors.

Methods

This cross-sectional study examined sleep quality as a mechanism linking stress and psychosocial outcomes and explored gender differences.

Results

Adolescents (N = 236; Mean = 15.66; SD = 1.07, 46.19% female) completed self-report measures assessing sleep quality and psychosocial outcomes. Structural equation modeling was used to test the potential mediating effect of sleep quality on associations between stress and psychosocial outcomes. Results indicated sleep quality accounted for 82.0% of the total effect of stress on school functioning (β = -0.45, p < 0.001) and 61.9% of the total effect of stress on pain (β = 0.14, p < 0.001). A larger indirect effect of sleep quality on school functioning (βdiff  = -0.27, p = 0.006) emerged for boys than girls, and the effect of sleep quality on pain was significant only for girls (β = 0.20, p = 0.003, 65.0% of total effect).

Conclusion

Sleep quality explained a large proportion of the cross-sectional association between stress and school functioning and pain. Sleep quality represents a modifiable transdiagnostic pathway that may buffer the effects of stress in adolescence.

Early-life bisphenol A exposure causes detrimental age-related changes in anxiety, depression, learning, and memory in juvenile and adult male rats: Involvement of NMDAR/PSD-95-PTEN/AKT signaling pathway

Bisphenol A (BPA) is an endocrine disruptor monomer that is widely used in the manufacturing of epoxy resins and polycarbonate plastics. Several lines of evidence indicate the function of the pre- or perinatally PI3K/AKT signaling pathway in the development of psychiatric disorders. The present study aimed to evaluate for the first time the effect of modifying the NMDAR/PSD-95-PTEN/AKT signaling pathway on behavioral and synaptic plasticity of early-life BPA exposure and its long-lasting influence on juvenile and adulthood stages of development. We investigated the effects of oral BPA doses of 50 and 125 mg/kg/day on the prefrontal cortex (PFC) and hippocampus of male Sprague Dawley rats from postnatal day (PND) 18-60 and PND 18-95, which correspond to juvenile and adolescent stages, respectively. Subsequently, we performed a series of rat behavioral tests, including the open field, elevated plus-maze, forced swimming, and Y-maze. Notably, neurotransmitter levels such as dopamine, serotonin, and gamma-aminobutyric acid, levels of postsynaptic density protein 95 and cAMP response element-binding protein, as well as mRNA levels of N-methyl-D-aspartate receptor subunits, fluctuated between reduction and elevation in the PFC and hippocampus. Furthermore, phosphatase and tensin (PTEN) mRNA and protein levels were upregulated in both brain areas, while PI3K, protein kinase B (AKT) and mammalian target of rapamycin (mTOR) mRNA and protein levels were decreased. Finally, our findings indicate that postnatal BPA exposure promotes long-term anxiety and depressive-like behaviors, as well as cognitive impairment, via modulation of the NMDAR/PSD-95-PTEN/AKT pathway. These findings could help to elucidate the potential developmental and neurobehavioral effects of early-life BPA exposure.

Variation in diurnal cortisol patterns among the Indigenous Shuar of Amazonian Ecuador

OBJECTIVES

The hypothalamic-pituitary-adrenal (HPA) axis and its primary end product, the glucocorticoid cortisol, are major components of the evolved human stress response. However, most studies have examined these systems among populations in high-income settings, which differ from the high pathogen and limited resource contexts in which the HPA axis functioned for most of human evolution.

METHODS

We investigated variability in diurnal salivary cortisol patterns among 298 Indigenous Shuar from Amazonian Ecuador (147 males, 151 females; age 2-86 years), focusing on the effects of age, biological sex, and body mass index (BMI) in shaping differences in diurnal cortisol production. Saliva samples were collected three times daily (waking, 30 minutes post-waking, evening) for three consecutive days to measure key cortisol parameters: levels at waking, the cortisol awakening response, the diurnal slope, and total daily output.

RESULTS

Age was positively associated with waking levels and total daily output, with Shuar juveniles and adolescents displaying significantly lower levels than adults (p < .05). Sex was not a significant predictor of cortisol levels (p > .05), as Shuar males and females displayed similar patterns of diurnal cortisol production across the life course. Moreover, age, sex, and BMI significantly interacted to moderate the rate of diurnal cortisol decline (p = .027). Overall, Shuar demonstrated relatively lower cortisol concentrations than high-income populations.

CONCLUSIONS

This study expands the documented range of global variation in HPA axis activity and diurnal cortisol production and provides important insights into the plasticity of human stress physiology across diverse developmental and socioecological settings.

Echoes of conflict and displacement in maternal health: Life-course violence, timing, and maternal stress after childbirth at the northern Thailand-Myanmar border

Armed conflict, displacement, and related violence is escalating globally, concentrated among civilians and migrants in border areas, and poses grave harms to women and children. The current study investigates how women's life-course experiences of conflict and displacement are linked to maternal stress and health outcomes after childbirth at the Thailand-Myanmar border, specifically stress, mental health, and cardiometabolic outcomes. Analyses are based on a cross-sectional population-based maternal and child health survey of 701 mothers, collected in 2017-18 in northern Thailand along the Myanmar border, including in camps, worksites, and residential homes. Results suggest that how conflict violence shapes contemporary stress and health depends on the outcome, level and timing of conflict violence exposure, and subsequent contextual threats and deprivation in displacement contexts. Past conflict violence was associated with symptoms of perceived stress (PS) and generalized anxiety disorder (GAD) but not depression. It was also associated with hypothalamic-pituitary-adrenal (HPA) axis activity (hair cortisol concentration) and adiposity (waist circumference and waist-to-hip ratio). Additionally, past conflict violence that began in childhood was particularly salient for PS, GAD, and adiposity; and level and timing of violence were salient jointly for HPA activity. Post-displacement factors also independently predicted higher blood pressure and played a potentially partial mediating role in the association between conflict exposure and both PS and GAD symptoms.

Early-life adversity severity, timing, and context type are associated with SLC6A4 methylation in emerging adults: Results from a prospective cohort study

BACKGROUND

Epigenetic modifications, including DNA methylation (DNAm), can play a role in the biological embedding of early-life adversity (ELA) through serotonergic mechanisms. The current study examines methylation of the CpG island in the promoter region of the stress-responsive serotonin transporter gene (SLC6A4) and is the first to jointly assess how it is influenced by ELA severity, timing, and type-specifically, deprivation and threat.

METHODS

We use data from 627 Youth Emotion Project study participants, recruited from two US high schools. Using adjusted linear regressions, we analyze DNA collected in early adulthood from 410 participants and ELA based on interviewer-rated responses from concurrent Childhood Trauma Interviews, adjusting for survey-measured covariates.

RESULTS

ELA robustly predicted mean CpG island SLC6A4 DNAm percent across 71 CpG sites. Each additional major-severity ELA event was associated with a 0.121-percentage-point increase (p<0.001), equating to a 0.177 standard deviation (sd) higher DNAm level (95 % CI: 0.080, 0.274) with each 1-sd higher adversity score. When modeled separately, both childhood and adolescent ELA predicted SLC6A4 DNAm. When modeled jointly, adolescent ELA was most strongly predictive, and child adversity remained significantly associated with DNAm through indirect associations via adolescent adversity. Additionally, the ELA-SLC6A4 DNAm association may vary by adversity type. Across separate models for childhood and adolescent exposures, deprivation coefficients are positive and statistically significant. Meanwhile, threat coefficients are positive and not significantly significant but do not statistically differ from deprivation coefficients. In models including all ELA dimensions, one major adolescent deprivation event is associated with a 0.222-percentage-point increased SLC6A4 DNAm (p<0.05), or a 1-sd higher deprivation score with a 0.157-sd increased DNAm.

CONCLUSION

Results further implicate epigenetic modification on serotonergic neurotransmission via DNAm in the downstream sequelae of ELA-particularly adolescent deprivation-and support preventive interventions in adolescence to mitigate biological embedding.

Early Adolescent Predictors of Young Adults' Distress and Adaptive Coping During the COVID-19 Pandemic: Findings From a Longitudinal Cohort Study

We examined early adolescent predictors of later distress and adaptive coping in early adulthood, using data from a prospective longitudinal cohort study (n = 786). In early adolescence (age 13), we assessed indicators of mental health (internalizing symptoms), stressor exposure (cumulative stressful life events), and family socialization (supportive parent-child interactions). In early adulthood (age 22), during the first COVID-19-related Swiss national lockdown, we assessed cumulative pandemic-related stressors, distress (poor well-being, hopelessness, and perceived disruptions to life) and adaptive coping. Early adolescent internalizing symptoms predicted lower well-being, more hopelessness, and perceived lifestyle disruptions in early adulthood, during the pandemic. Cumulative stressful life events during early adolescence moderated the association between cumulative pandemic-related stressors and perceived lifestyle disruptions. Supportive parent-child interactions fostered subsequent engagement in adaptive coping, which, in turn, predicted less hopelessness and better well-being. Findings reveal that early adolescent development is linked with distress and adaptive coping in later periods.

Isolated during adolescence: long-term impact on social behavior, pain sensitivity, and the oxytocin system in male and female rats

BACKGROUND

Adolescent social isolation (ASI) has profound long-term effects on behavioral and neural development. Despite this, the specific long-term impact of ASI during different adolescent stages and across sexes remain underexplored.

METHODS

Our study addresses this gap by examining the effects of early- and late- adolescent social isolation on both male and female rats. Rats were either isolated (or group-housed) starting from PD 21 (early) or PD 42 (late) for three weeks and then rehoused into groups. In adulthood (PD 90), rats underwent a battery of tests: elevated plus-maze, open field, novel object recognition, social interaction and social recognition memory and hotplate tests. Finally, we analyzed oxytocin receptor binding in several regions in the brains of a second cohort of rats.

RESULTS

Both, male and female rats from the late adolescent social isolation (LASI) groups spent significantly less time interacting in the social interaction test. Additionally, we observed a general decrease in social recognition memory regardless of sex. Both male ASI groups demonstrated heightened thermal pain sensitivity, while the opposite was observed in early adolescent social isolation (EASI) female rats. In the brain, we observed changes in oxytocin receptor (OTR) binding in the paraventricular nucleus of the hypothalamus (PVN) and paraventricular nucleus of the thalamus (PVT) and central amygdala (CeA) with the largest changes in EASI and LASI female rats.

CONCLUSION

Our model demonstrates long-lasting alterations on behavior and oxytocin receptor binding levels following ASI providing insights into the long-term effects of ASI in a time- and sex-specific manner.

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).

Youth daily stressors predict their parents' wellbeing

The experiences of family members are intertwined and the stressors of one family member may crossover to affect the wellbeing of others in the family as well. Prior studies have established that the stress experienced by one marital spouse can affect the wellbeing of their spouse and that parent stress can affect their children's wellbeing. This study used daily diary data from 318 parent-youth dyads (Mean age parent = 41.34, adolescent = 13.18) to examine whether youth daily stressors (i.e., interpersonal conflicts and demands), were associated with parent wellbeing and cortisol levels. Parents report more negative affect, more physical symptoms (i.e., headaches/fatigue/stomach problems), and exhibit higher bedtime cortisol levels on days when youth experience stressors. These effects were consistent across different types of youth stressors, including parent, family, and non-family stressors. Youth stress may have important implications for parent wellbeing.

Chronic ingestion of soy peptide supplementation reduces aggressive behavior and abnormal fear memory caused by juvenile social isolation

Juvenile loneliness is a risk factor for psychopathology in later life. Deprivation of early social experience due to peer rejection has a detrimental impact on emotional and cognitive brain function in adulthood. Accumulating evidence indicates that soy peptides have many positive effects on higher brain function in rodents and humans. However, the effects of soy peptide use on juvenile social isolation are unknown. Here, we demonstrated that soy peptides reduced the deterioration of behavioral and cellular functions resulting from juvenile socially-isolated rearing. We found that prolonged social isolation post-weaning in male C57BL/6J mice resulted in higher aggression and impulsivity and fear memory deficits at 7 weeks of age, and that these behavioral abnormalities, except impulsivity, were mitigated by ingestion of soy peptides. Furthermore, we found that daily intake of soy peptides caused upregulation of postsynaptic density 95 in the medial prefrontal cortex and phosphorylation of the cyclic adenosine monophosphate response element binding protein in the hippocampus of socially isolated mice, increased phosphorylation of the adenosine monophosphate-activated protein kinase in the hippocampus, and altered the microbiota composition. These results suggest that soy peptides have protective effects against juvenile social isolation-induced behavioral deficits via synaptic maturation and cellular functionalization.

Trauma-sensitive school concepts for students with a refugee background: a review of international studies

Children and adolescents with a refugee background are at high risk for traumatization. Once they arrive in safe countries, schools are the institutions where teachers are responsible for caring for them sensitively and competently. Furthermore, schools are organized in learning groups consisting of multiple peers of the same age, which provides excellent opportunities for social learning and experiences of social support. In this respect, schools are the appropriate places where preventive concepts can be applied to students with a refugee background. This systematic review summarizes studies that examine or evaluate existing international concepts of trauma-sensitive schools for supporting traumatized students with a refugee background. Based on N = 41 selected articles, 17 relevant concepts of trauma-sensitive schools were identified. In 35.3% of the concepts, traumatized students with a refugee background are explicitly included in the target group of the concept, while 47.1% of the concepts refer to groups of students with trauma as a result of various adverse childhood experiences, which also occur more frequently within the population of refugee children and adolescents 17.6% of the concepts contain specific adaptations for pupils with a refugee background. The majority of these concepts were developed in the United States. Additional concepts can be reported for Australia, the United Kingdom, Turkey, and Cambodia. Based on available empirical data, no significant effectiveness regarding the researched concepts' effects on academic and other school-related data can be determined. Although some studies indicate positive effects concerning school-related target variables, most of the studies have only limited significance due to inadequate research designs and methodological deficiencies. Therefore, there is a great need for further development, careful implementation, and evaluation of trauma-sensitive concepts in schools, especially for the growing group of refugee students.

Changes in Internalizing Symptoms During the COVID-19 Pandemic in a Transdiagnostic Sample of Youth: Exploring Mediators and Predictors

The COVID-19 pandemic is a chronically stressful event, particularly for youth. Here, we examine (i) changes in mood and anxiety symtpoms, (ii) pandemic-related stress as a mediator of change in symptoms, and (ii) threat processing biases as a predictor of increased anxiety during the pandemic. A clinically well-characterized sample of 81 youth ages 8-18 years (M = 13.8 years, SD = 2.65; 40.7% female) including youth with affective and/or behavioral psychiatric diagnoses and youth without psychopathology completed pre- and during pandemic assessments of anxiety and depression and COVID-related stress. Forty-six youth also completed a threat processing fMRI task pre-pandemic. Anxiety and depression significantly increased during the pandemic (all ps < 0.05). Significant symptom change was partially mediated by pandemic stress and worries. Increased prefrontal activity in response to neutral faces pre-pandemic was associated with more intense parent-reported anxiety during the pandemic (all Fs(1.95,81.86) > 14.44, ps < 0.001). The present work extends existing knowledge on the mediating role of psychological stress on symptoms of anxiety and depression in youth.

Stress regulates Alzheimer's disease progression via selective enrichment of CD8+ T cells

This study investigates stress's impact on Alzheimer's disease (AD) using male APP/PS1 transgenic mice. Negative stressors (chronic social defeat, restraint) and positive hedonia (environmental enrichment, EE) were applied. Stress worsens AD pathology, while EE slows progression. Brain RNA sequencing reveals interleukin-6 (IL-6) and IL-10 as key stress-related AD regulators. Flow cytometry shows that the CD8+/CD4+ T cell ratio shifts in response to stress exposure and EE. Stress exposure increases CD8+/CD4+ ratio, opposite to EE. Depletion and enrichment of CD8+ T cells both accelerate AD, indicating immune intervention's negative impact. Stress management and balanced immunity may aid AD therapy, highlighting novel potential treatment.

What lies beneath: White matter microstructure in pediatric myalgic encephalomyelitis/chronic fatigue syndrome using diffusion MRI

Recent studies in adults with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) suggest that changes in brain white matter microstructural organization may correlate with core ME/CFS symptoms, and represent a potential biomarker of disease. However, this has yet to be investigated in the pediatric ME/CFS population. We examined group differences in macrostructural and microstructural white matter properties, and their relationship with clinical measures, between adolescents recently diagnosed with ME/CFS and healthy controls. Forty-eight adolescents (25 ME/CFS, 23 controls, mean age 16 years) underwent brain diffusion MRI, and a robust multi-analytic approach was used to evaluate white and gray matter volume, regional brain volume, cortical thickness, fractional anisotropy, mean/axial/radial diffusivity, neurite dispersion and density, fiber density, and fiber cross section. From a clinical perspective, adolescents with ME/CFS showed greater fatigue and pain, poorer sleep quality, and poorer performance on cognitive measures of processing speed and sustained attention compared with controls. However, no significant group differences in white matter properties were observed, with the exception of greater white matter fiber cross section of the left inferior longitudinal fasciculus in the ME/CFS group compared with controls, which did not survive correction for intracranial volume. Overall, our findings suggest that white matter abnormalities may not be predominant in pediatric ME/CFS in the early stages following diagnosis. The discrepancy between our null findings and white matter abnormalities identified in the adult ME/CFS literature could suggest that older age and/or longer illness duration influence changes in brain structure and brain-behavior relationships that are not yet established in adolescence.

The age-varying effects of adolescent stress on impulsivity and sensation seeking

Adolescence is defined in part by heightened exposure and sensitivity to stressors. In a longitudinal cohort of youth at risk for substance use problems, we examined the age-varying relationship between stress exposure and traits that are central to the dual systems model. The positive associations between stress exposure, impulsivity, sensation seeking varied as function of age. Specifically, the influence of stress exposure on impulsivity strengthened during early adolescence and remained stable into early adulthood, while the influence of stress exposure on sensation seeking strengthened from early- to mid-adolescence and weakened thereafter. These findings suggest that the maturational imbalance between the capacity to regulate impulsive tendencies and sensation seeking may be exaggerated for youth who are exposed to a high number of stressors.

Pain-related stigma as a social determinant of health in diverse pediatric pain populations

Pediatric patients with invisible symptomology, such as chronic pain syndromes, are more likely to experience pain-related stigma and associated discrimination by others, including medical providers, peers, school personnel, and family members. The degree of this pain-related stigma may depend on several social dimensions, including observer (e.g., attentional and implicit biases) and patient characteristics (e.g., racial identity, socioeconomic stressors). In this mini-review, we introduce the concept of pain-related stigma, and the intersectionality of stigma, within the context of social determinants of health in pediatric pain populations. Stigma theory, observer attentional biases, healthcare provider implicit/explicit biases, adverse childhood experience, and psychophysiology of socio-environmental stressors are integrated. Several ethical, clinical, and research implications are also discussed. Because the study of pain-related stigma in pediatric pain is in its infancy, the purpose of this conceptual review is to raise awareness of the nuances surrounding this social construct, propose avenues through which stigma may contribute to health inequities, present frameworks to advance the study of this topic, and identify areas for further investigation.

Physiological stress reactivity in pediatric cancer survivors treated with chemotherapy

Children who experience early life stress demonstrate changes to their stress responses, which may modulate long-term health. Childhood cancer presents significant stress during diagnosis, treatment, and survivorship. We hypothesized that children who have completed chemotherapy treatment for ALL will demonstrate altered hormone patterns in response to a stressor compared with healthy controls. Twelve pediatric ALL survivors and 12 healthy controls completed the Trier Social Stress Test. Salivary samples, heart rate, and self-report ratings of stress were collected at baseline, pretest, and posttest. Between group comparison showed baseline (interleukin [IL]-8) was significantly higher in the survivor group versus controls (survivors: 89.9, 40.1-544.9 pg ml^-1 ; controls: 30.7, 5.6-241.9 pg ml^-1 , p = .001) as was peak (IL-8) (survivors: 147.1, 71.6-1177.6 pg ml^-1 ; controls: 75.5, 28.6-698.6 pg ml^-1 ). Peak salivary alpha-amylase (sAA) concentration was significantly lower in the survivor group (survivors: 69.3, 19.4-195.5 U ml^-1 ; controls: 91.2, 27.7-213.7 U ml^-1 ; p = .04). Repeated measures ANOVA revealed significant main effects for time on cortisol (F_{(2.35, 50.81)}  = 5.9, p < .01), sAA (F_{(1.56, 33.17)}  = 6.6, p < .01), stress ratings (F_{(3.42, 88.14)}  = 53.4, p < .001), and heart rate (F_{(8, 83)}  = 16.8, p < .05). Significant main effects for group were observed for IL-8 (F_{(1, 23)}  = 8.2, p < .01) and tumor necrosis factor-α (F_{(1, 23)}  = 6.8, p < .05). Significant interaction effects for group × time were found for sAA (F_{(5, 106)}  = 2.8, p < .05). Our results indicate that childhood ALL survivors have similar responses to stress as healthy controls, but lower sympatho-adrenal-medullary reactivity. Therefore, altered stress regulation may present a pathway modulating long-term health in this population.

Linking Puberty and the Gut Microbiome to the Pathogenesis of Neurodegenerative Disorders

Puberty is a critical period of development marked by the maturation of the central nervous system, immune system, and hypothalamic-pituitary-adrenal axis. Due to the maturation of these fundamental systems, this is a period of development that is particularly sensitive to stressors, increasing susceptibility to neurodevelopmental and neurodegenerative disorders later in life. The gut microbiome plays a critical role in the regulation of stress and immune responses, and gut dysbiosis has been implicated in the development of neurodevelopmental and neurodegenerative disorders. The purpose of this review is to summarize the current knowledge about puberty, neurodegeneration, and the gut microbiome. We also examine the consequences of pubertal exposure to stress and gut dysbiosis on the development of neurodevelopmental and neurodegenerative disorders. Understanding how alterations to the gut microbiome, particularly during critical periods of development (i.e., puberty), influence the pathogenesis of these disorders may allow for the development of therapeutic strategies to prevent them.

Getting under the skin: long-term links of adolescent peer relationship difficulties to adult vagal tone

Understanding whether and how the absence of positive relationships may predict longer-term physical health outcomes is central to building a working conceptual model of the interplay of social and physical development across the lifespan. This study sought to examine the extent to which difficulties establishing positive social relationships from adolescence onward serve as long-term predictors of low adult vagal tone, which in turn has been linked to numerous long-term health problems. A diverse community sample of 141 individuals was followed via multiple methods and reporters from age 13 to 29. Across this span, social relationship quality was assessed via close friend and peer reports, observations of romantic interactions, and self-reported romantic relationship satisfaction. A range of potential personality and functional covariates was also considered. Vagal tone while at rest was assessed at age 29. Adult vagal tone was predicted across periods as long as 16 years by: adolescents' difficulty establishing themselves as desirable companions among peers; early adults' inability to establish strong close friendships; and lack of warmth in romantic relationships as an adult. Poor early adult friendship quality statistically mediated the link from adolescent peer difficulties to adult vagal tone. A range of potential confounding factors was examined but was not linked to vagal tone. Within the limits of the correlational design of the study, robust connections between adult vagal tone and social relationship quality from adolescence onward suggest at least a possible mechanism by which relationship difficulties may get 'under the skin' to influence future physiological functioning.

Randomized controlled trial of a mindfulness-based intervention in adolescents from the general population: The Mindfulteen neuroimaging study protocol

AIM

Adolescence is a period of vulnerability to stress. Increased anxiety during this period has been associated with the later development of mental disorders, hence the growing interest for interventions that could decrease stress reactivity and improve cognitive control in adolescents. Mindfulness-based interventions have demonstrated their efficacy on stress reactivity and anxiety in adults, but evidence is lacking in youth.

METHODS

The Mindfulteen Study is a 3-year longitudinal cohort with a nested randomized controlled trial examining the effectiveness of mindfulness-based interventions for adolescents. Young adolescents from the general population, aged between 13 and 15 years old, with no history of current mental health disorder (apart from past mood disorders or current anxiety disorders) are included and stratified into low or high anxiety based on trait anxiety scores before being randomized to early or late 8-week intervention groups. Primary outcomes are based on neuroimaging data (i.e., structural and functional measures in the cortico-limbic network) while secondary outcomes are psychological (i.e., anxiety and stress-associated dimensions) and biological (i.e., cortisol, inflammatory and redox markers). Assessments are performed at baseline, immediately after intervention or waiting time and after 18 months of intervention.

CONCLUSION

To the best of our knowledge, this is the first randomized controlled trail examining the effect of a mindfulness-based intervention in young adolescents from the general population based on the measurement and analyses of psychological, neuroimaging and biological data.

Determinants of Chronic Biological Stress, Measured as Hair Cortisol Concentration, in a General Population of Adolescents: From Individual and Household Characteristics to Neighborhood Urbanicity

Chronic biological stress may adversely affect adolescents' physical and mental health, but insight in the personal and environmental factors that determine chronic stress is limited. We measured 3-month cumulative hair cortisol concentration (HCC) in 419 adolescents, participating in the Flemish Environment and Health Study. Adolescents' health and lifestyle characteristics, household and neighborhood socio-economic status as well as neighborhood urbanicity were assessed as potential determinants of HCC, using multiple linear regression models. We additionally explored heterogeneity of our results by sex. HCC were significantly higher in boys from densely populated neighborhoods, the association was not significant in girls. Accordingly, boys living outside cities had significantly lower HCC than boys, living in cities. HCC was significantly lower in adolescents with an optimal vitality, a measure of a positive mental health status. In adolescent girls, menarcheal status (pre-/postmenarche) was a significant determinant of HCC. Our findings are the first to suggest that residential urbanicity may have an impact on chronic biological stress in a general population of adolescent boys.

The Acute Relationship between Affective States and Stress Biomarkers in Ethnic Minority Youths

Background: Whether affective states acutely predict the hypothalamic–pituitary–adrenal (HPA) axis activities and whether energy balance-related behaviors moderate the affect–HPA axis relationship in obese youths are not well-understood. Methods: 87 mostly obese (94.3% obese) minority adolescents (mean: 16.3 ± 1.2 years old; 56.8% Latino and 43.2% African American) participated in a randomized crossover trial in an observation laboratory, where they received either high-sugar/low-fiber (HSLF) or low-sugar/high-fiber (LSHF) meals first and then crossed over in the next visit 2–4 weeks later. During each visit, they rated five affective states and provided a saliva sample every 30 min for the first 5 h and wore a waist-worn accelerometer. The association between the affect ratings and cortisol levels in the subsequent 30 min and the moderation effect of energy balance-related behavior were examined using multilevel models. Results: Within-person negative affect (β = 0.02, p = 0.0343) and feeling of panic (β = 0.007, p = 0.004) were acutely related to the subsequent cortisol level only during the HSLF condition. The time spent in moderate-to-vigorous physical activity did not moderate the acute relationship between affect and the subsequent cortisol level. Conclusions: Negative affect could be acutely related to heightened HPA axis activities in youths, but only when they were exposed to meals with high sugar and low fiber content. These results suggest that the meals’ sugar and fiber content may modulate HPA axis reactivity to negative affect in youths.

Sustained effects of left-behind experience during childhood on mental health in Chinese university undergraduates

Rapid industrialization and urbanization in China have resulted in labor migrants leaving children behind. For left-behind children (LBC), disrupted parental attachment may increase the risk of psychiatric morbidity in adulthood. To investigate psychopathological consequences for university students who were LBC and to estimate the effects of one or both parents being migrants, the duration of left-behind experience, and parental absence during critical periods of growth on psychiatric morbidity. We conducted an annual survey of all freshmen at a Chinese university from 2014 to 2018. The questionnaire collected information on left-behind experiences and psychiatric morbidity using standardized self-report instruments. Regression coefficients derived from logistic regression were used to measure the associations among total time left behind, absence of one parent or both parents, age when left behind and psychopathological consequences. A total of 42,505 students were included. Students who were LBC had more psychopathology, including depression, anxiety, somatoform disorder, obsessive-compulsive disorder, self-reported suicide attempts and deliberate self-harm, than those who were not. Students for whom one or both parents were migrants showed a greater risk of psychiatric morbidity. The risk of psychiatric morbidity increased with the length of parental absence. Left-behind experience during childhood represents sustained impacts for university students into early adulthood. The higher prevalence of psychiatric morbidity in young adults who experienced the absence of one or both of their parents, especially in their early childhood, suggests that other factors besides attachment, such as protection from other risks, are important and that further research is necessary.

Measurement properties of the simplified Chinese version of Nonrestorative Sleep Scale in adolescents

This study aimed to assess the measurement properties of a simplified Chinese version of the Nonrestorative Sleep Scale (NRSS) among adolescents. We obtained a simplified Chinese NRSS by the standard forward-backward translation procedures and administered it to 486 students who were attending Grade 7-11 in Nanjing, China. Furthermore, Pittsburgh Sleep Quality Index, Athens Insomnia Scale, Centre for Epidemiological Studies Depression Scale, and Toronto Hospital Alertness Test were also self-completed for measuring sleep quality, insomnia, depression and alertness respectively. The sample was randomly split into two halves, with the first half used to explore the scale structure by exploratory factor analysis (EFA), and the second half used to confirm the identified structure by confirmatory factor analysis (CFA). A total of 481 adolescents (49% male) with a mean age of 16 years (range: 13-18) completed this study. In the other half of 250 adolescents, the root mean square error of approximation (RMSEA), standardised root mean square residual, and comparative fit index (CFI) in CFA, which tested the four-factor structure obtained from EFA, were 0.062, 0.051 and 0.975, respectively. Convergent validity was demonstrated from a significant correlation of the simplified Chinese NRSS with sleep quality (r = -0.62), insomnia (r = -0.71), depression (r = -0.60) and alertness (r = 0.54). The internal consistency and test-retest reliability for the global scale were 0.83 and 0.86 respectively. Measurement invariance was established between males and females with the changes of both CFI and RMSEA < 0.01. The simplified Chinese NRSS is valid and reliable for measuring NRS among Chinese adolescents.

A Lifespan Development Theory of Insecure Attachment and Internalizing Symptoms: Integrating Meta-Analytic Evidence via a Testable Evolutionary Mis/Match Hypothesis

Attachment scholars have long argued that insecure attachment patterns are associated with vulnerability to internalizing symptoms, such as depression and anxiety symptoms. However, accumulating evidence from the past four decades, summarized in four large meta-analyses evaluating the link between insecure attachment subtypes and internalizing symptoms, provide divergent evidence for this claim. This divergent evidence may be accounted for, at least in part, by the developmental period under examination. Specifically, children with histories of deactivating (i.e., insecure/avoidant) but not hyperactivating (i.e., insecure/resistant) attachment patterns in infancy and early childhood showed elevated internalizing symptoms. In contrast, adolescents and adults with hyperactivating (i.e., insecure/preoccupied) but not deactivating (i.e., insecure/dismissing) attachment classifications showed elevated internalizing symptoms. In this paper, we summarize findings from four large meta-analyses and highlight the divergent meta-analytic findings that emerge across different developmental periods. We first present several potential methodological issues that may have contributed to these divergent findings. Then, we leverage clinical, developmental, and evolutionary perspectives to propose a testable lifespan development theory of attachment and internalizing symptoms that integrates findings across meta-analyses. According to this theory, subtypes of insecure attachment patterns may be differentially linked to internalizing symptoms depending on their mis/match with the developmentally appropriate orientation tendency toward caregivers (in childhood) or away from them (i.e., toward greater independence in post-childhood). Lastly, we offer future research directions to test this theory.

The interactions between childhood adversities and recent stress were associated with early-adulthood depression among Chinese undergraduate students

BACKGROUND

It is widely acknowledged that childhood adversities (CAs) and recent stress are potential risk factors for adult depression. However, the mechanism(s) by which interactions of CAs with recent stress affect adult depression remain unclear.

AIMS

To investigate the predictive association of the interaction among CAs and recent stress with early-adult depression.

METHOD

We conducted an annual survey of all freshmen for the period of 2016-2018 in a Chinese comprehensive university, with a sample size of 23,206. An online questionnaire including standardized self-report instruments was used to assess sociodemographic factors, childhood experiences of left-behind (CELB), and maltreatments (CEMTs) including beating (CEB), neglect (CEN), sexual abuse (CESA), recent stress, and current depression (measured by the 9-item Patient Health Questionnaire).

RESULTS

The correlation of Individual CAs and recent stress was significant. In addition to their significant independent/direct incremental effects, all surveyed CAs were associated with increased severity of early-adult depression, and increased frequency of clinically significant depression (CSD), through significant associations with recent stress (mediation effect). History of CEMTs including CEB, CEN, and CESA significantly increased the effects of recent stress on depression (moderation effect).

CONCLUSIONS

Chinese undergraduate students reported frequent history of exposure to CAs, which increased the likelihood of depression in early adulthood, not only directly but also through the increasing the likelihood (mediation effect) and impact (moderation effect) of recent stress on depression. These novel findings may help to extend our understanding of environmental determinants of depression, and to guide further research, clinical practice, and policy in this context.

The impact of adolescent stress on nicotine use and affective disorders in rodent models

Recent findings indicate that stress exposure during adolescence contributes to the development of both nicotine use and affective disorders, suggesting a potential shared biological pathway. One key system that may mediate the association between adolescent stress and nicotine or affective outcomes is the hypothalamic-pituitary-adrenal (HPA) axis. Here we reviewed evidence regarding the effects of adolescent stress on nicotine responses and affective phenotypes and the role of the HPA-axis in these relationships. Literature indicates that stress, possibly via HPA-axis dysfunction, is a risk factor for both nicotine use and affective disorders. In rodent models, adolescent stress modulates behavioural responses to nicotine and increases the likelihood of affective disorders. The exact role that the HPA-axis plays in altering nicotine sensitivity and affective disorder development after adolescent stress remains unclear. However, it appears likely that adolescent stress-induced nicotine use and affective disorders are precipitated by repetitive activation of a hyperactive HPA-axis. Together, these preclinical studies indicate that adolescent stress is a risk factor for nicotine use and anxiety/depression phenotypes. The findings summarized here suggest that the HPA-axis mediates this relationship. Future studies that pharmacologically manipulate the HPA-axis during and after adolescent stress are critical to elucidate the exact role that the HPA-axis plays in the development of nicotine use and affective disorders following adolescent stress.

Adolescent Stress Reduces Adult Morphine-Induced Behavioral Sensitization in C57BL/6J Mice

Deaths related to opioid use have skyrocketed in the United States, leading to a public health epidemic. Research has shown that both biological (genes) and environmental (stress) precursors are linked to opioid use. In particular, stress during adolescence-a critical period of frontal lobe development-influences the likelihood of abusing drugs. However, little is known about the biological mechanisms through which adolescent stress leads to long-term risk of opioid use, or whether genetic background moderates this response. Male and female C57BL/6J and BALB/cJ mice were exposed to chronic variable social stress (CVSS) or control conditions throughout adolescence and then tested for morphine locomotor sensitization or morphine consumption in adulthood. To examine possible mechanisms that underlie stress-induced changes in morphine behaviors, we assessed physiological changes in response to acute stress exposure and prefrontal cortex (PFC) miRNA gene expression. Adolescent stress did not influence morphine sensitization or consumption in BALB/cJ animals, and there was limited evidence of stress effects in female C57BL/6J mice. In contrast, male C57BL/6J mice exposed to adolescent CVSS had blunted morphine sensitization compared to control animals; no differences were observed in the acute locomotor response to morphine administration or morphine consumption. Physiologically, C57BL/6J mice exposed to CVSS had an attenuated corticosterone recovery following an acute stressor and downregulation of twelve miRNA in the PFC compared to control mice. The specificity of the effects for C57BL/6J vs. BALB/cJ mice provides evidence of a gene-environment interaction influencing opioid behaviors. However, this conclusion is dampened by limited locomotor sensitization observed in BALB/cJ mice. It remains possible that results may differ to other doses of morphine or other behavioral responses. Long-term differences in stress reactivity or miRNA expression in C57BL/6J mice suggests two possible biological mechanisms to evaluate in future research.

Religious and Spiritual Development from Adolescence to Early Adulthood in the U.S.: Changes over Time and Sexual Orientation Differences

Adolescence is a critical time in the U.S. for religious development in that many young people eschew their religious identity as they enter adulthood. In general, religion is associated with a number of positive health outcomes including decreased substance use and depression. The current study compared the developmental patterns of religiosity and spirituality in heterosexual and sexual minority youth. The design was a secondary data analysis of the first five waves of the Longitudinal Study of Adolescent Health and Wellness (N = 337, 71.8% female). Using multilevel linear (for spirituality) and quadratic (for religiosity) growth models, the initial level and change over time in religiosity and spirituality, as well as the correlations between growth processes, were compared between heterosexual and sexual minority individuals. The heterosexual group had significantly higher initial religiosity levels than the sexual minority group. Religiosity decreased over time at a similar rate for the heterosexual and sexual minority groups. Spirituality significantly increased over time for the sexual minority group but not for the heterosexual youth. The change over time in religiosity and spirituality were significantly and positively correlated for heterosexual individuals but were uncorrelated for sexual minority individuals. Results indicate there are differences in religious development based on sexual minority status. Future research should take into account how these differential religious and spiritual developmental patterns seen in heterosexual and sexual minority youth might predict various health outcomes.

Youth Internalizing Problems and Changes in Parent-Child Relationships Across Early Adolescence: Lability and Developmental Trends

Few longitudinal studies examine how changes in parent-child relationships are associated with changes in youth internalizing problems. In this longitudinal study, we investigated how developmental trends (linear change) and year-to-year lability (within-person fluctuations) in parental warmth and hostility across Grade 6-8 predict youth internalizing problems in Grade 9 (N = 618) and whether these linkages differ for boys and girls. Developmental trends (greater decreases in warmth, increases in hostility) were associated with more youth internalizing problems. Greater year-to-year lability (more fluctuations) in father hostility and warmth were also associated with more internalizing problems. Greater lability in mother warmth was associated with more internalizing problems for girls only. The strongest effects of lability on internalizing problems were found for youth with the highest lability scores. This study underscores the importance of differentiating developmental trends from lability in parent-child relationships, both of which may be important for youth internalizing problems.

Neuroendocrine and neuroimmune responses in male and female rats: evidence for functional immaturity of the neuroimmune system during early adolescence

Adolescence is a developmental period characterized by rapid behavioral and physiological changes, including enhanced vulnerability to stress. Recent studies using rodent models of adolescence have demonstrated age differences in neuroendocrine responses and blunted neuroimmune responding to pharmacological challenges. The present study was designed to test whether this neuroimmune insensitivity would generalize to a non-pharmacological stress challenge. Male and female adolescent (P29-33) and adult (P70-80) Sprague Dawley rats were exposed to intermittent footshock for one-, two-, or two-hours + recovery. Plasma corticosterone and progesterone levels as well as gene expression of several cytokines and c-Fos gene expression in the paraventricular nucleus of the hypothalamus (PVN), the medial amygdala (MeA), and the ventral hippocampus (vHPC) were analyzed. The results of the present study demonstrated differences in response to footshock, with these differences dependent on age, sex, and brain region of interest. Adult males and females demonstrated time-dependent increases in IL-1β and IL-1R2 in the PVN, with these changes not evident in adolescent males and substantially blunted in adolescent females. TNFα expression was decreased in all regions of interest, with adults demonstrating more suppression relative to adolescents and age differences more apparent in males than in females. IL-6 expression was affected by footshock predominantly in the vHPC of adolescent and adult males and females, with females demonstrating prolonged elevation of IL-6 gene expression. In summary, central cytokine responses to acute stressor exposure are blunted in adolescent rats, with the most pronounced immaturity evident for the brain IL-1 signaling system.

The Influence of an Acute Exercise Bout on Adolescents' Stress Reactivity, Interference Control, and Brain Oxygenation Under Stress

Background

High psychosocial stress can impair executive function in adolescents, whereas acute exercise has been reported to benefit this cognitive domain. The aim of this study was to investigate whether an acute bout of aerobic exercise improves the inhibitory aspect of executive function and the associated dorsolateral prefrontal cortex (DLPFC) oxygenation when under stress.

Methods

Sixty male high school students aged 16–20 years performed a Stroop task (baseline condition) and were randomly assigned to an exercise group (30 min on ergometer at 70% of maximum heart rate) and a control group (30 min of reading). Subsequently, all participants underwent a modified Trier Social Stress Test, which included a Stroop task under enhanced stress. The Stroop tasks in both conditions were combined with functional near-infrared spectroscopy to record changes in DLPFC oxygenation in response to the tasks. Stress reactivity was measured with saliva samples (cortisol, alpha-amylase), heart rate monitoring, and anxiety scores.

Results

All stress parameters indicated increases in response to the stressor (p < 0.001), with higher alpha-amylase [t(58) = −3.45, p = 0.001, d = 1.93] and anxiety [t(58) = −2.04, p = 0.046, d = 0.53] reactions in the control compared to the exercise group. Controlling for these two parameters, repeated measures analyses of covariance targeting changes in Stroop interference scores showed no main effect of stress [F(1,58) = 3.80, p = 0.056, ηp² = 0.063] and no stress × group interaction [F(1,58) = 0.43, p = 0.517, ηp² = 0.008]. Similarly, there was no main effect of stress [F(1,58) = 2.38, p = 0.128, ηp² = 0.040] and no stress × group interaction [F(1,58) = 2.80, p = 0.100, ηp² = 0.047] for DLPFC oxygenation.

Conclusion

Our study confirms potentially health-enhancing effects of acute exercise on some of the physiological and psychological stress reactivity indicators. However, our data do not support the notion of an effect on interference control and DLPFC activation under stress.

Peri-adolescent asthma: Acute impacts on innate immune response, corticosterone, and microglia in mice

Asthma is highly comorbid with anxiety in youth. We investigated the hypothalamic-pituitary-adrenal (HPA) axis and microglia as mechanisms underlying asthma and anxiety comorbidity. We induced asthma symptoms in developing BALB/cJ mice with house dust mite (HDM) for airway inflammation and methacholine (MCH) for bronchoconstriction. On the last day of exposure, we analyzed samples at six timepoints. Lung IL-5 and IL-1β expression peaked 4 h after final HDM exposure. Circulating corticosterone was blunted in a sex- and treatment-specific temporal pattern. Hippocampal IL-1β expression and microglial area were marginally increased 24 h after MCH exposure. These results provide a foundation for further work investigating asthma-anxiety mechanisms.

Sleep and Parasympathetic Activity During Rest and Stress in Healthy Adolescents and Adolescents With Bipolar Disorder

OBJECTIVE

Sleep disruption contributes to the pathophysiology of mental disorders, particularly bipolar illness, but the biobehavioral mechanisms of this relationship are insufficiently understood. This study evaluated sleep duration, timing, and variability as prospective predictors of parasympathetic nervous system activity during rest and social stress in adolescents with bipolar disorder, reflecting sleep-related interference in stress regulatory systems that may confer vulnerability to mood episodes.

METHOD

Participants were adolescents with bipolar disorder (n = 22) and healthy adolescents (n = 27). Sleep duration and timing were measured by actigraphy for 1 week before a laboratory social stress task, during which high-frequency heart rate variability (HF-HRV) was indexed using electrocardiography. Multilevel models were used to evaluate group, sleep characteristics, and their interactions as predictors of initial HF-HRV and change in HF-HRV during rest and stress.

RESULTS

Associations between group and changes in HF-HRV during stress were moderated by sleep duration mean (z = 2.24, p = .025) and variability (z = -2.78, p = .006). There were also main effects of mean sleep duration on initial HF-HRV during rest (z = -5.37, p < .001) and stress (z = -2.69, p = .007). Follow-up analyses indicated that, in bipolar adolescents during stress, shorter and longer sleep durations were associated with lower initial HF-HRV (z = -5.44, p < .001), and greater variability in sleep duration was associated with less change in HF-HRV (z = -2.18, p = .029).

CONCLUSIONS

Sleep durations that are relatively short or long, which are characteristic of mood episodes, are associated with parasympathetic vulnerability to social stress in adolescents with bipolar disorder. Obtaining regular sleep of moderate duration may favorably affect responses to stress in bipolar youth.

Influences of victimization and comorbid conditions on substance use disorder outcomes in justice-involved youth: A discrete time survival mixture analysis

To understand how exposure to victimization during adolescence and the presence of comorbid psychological conditions influence substance use treatment entry and substance use disorder diagnosis from 14 to 25 years old among serious juvenile offenders, this study included 1,354 serious juvenile offenders who were prospectively followed over 7 years. Growth mixture modeling was used to assess profiles of early victimization during adolescence (14-17 years). Discrete time survival mixture analysis was used to assess time to treatment entry and substance use disorder diagnosis. Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) were used as predictors of survival time. Mixture models revealed three profiles of victimization: sustained poly-victimization, moderate/decreasing victimization, and low victimization. Youth in the sustained poly-victimization class were more likely to enter treatment earlier and have a substance use diagnosis earlier than other classes. PTSD was a significant predictor of treatment entry for youth in the sustained poly-victimization class, and MDD was a significant predictor of substance use disorder diagnosis for youth in the moderate/decreasing victimization class. Therefore, substance use prevention programming targeted at youth experiencing poly-victimization in early adolescence-especially those who have PTSD or MDD-is needed.

Associations of Social and Psychological Resources with Different Facets of Chronic Stress: A Study with Employed and Unemployed Adolescents

Adolescents navigate many psychosocial changes. A critical transition in adolescence is the one from school to work life. Both taking the first steps in work life and the failure to achieve this transition and being unemployed can engender elevated levels of stress during adolescence. Stress, especially when experienced chronically, is an important risk factor for mental health problems. Social and psychological resources may mitigate the experience of chronic stress. This study explored associations of social and family support, self-esteem, and self-efficacy with different dimensions of chronic stress in a sample of 1405 employed and unemployed adolescents (M(age) = 17.84, SD = 1.63, range: 14.05–26.12) in Switzerland. Unemployed adolescents showed higher stress levels overall. Higher levels of social and psychological resources were generally linked to lower stress levels. Social support and self-esteem predicted stress levels most consistently and strongly. On several stress dimensions, the association between higher self-esteem and lower stress levels was more pronounced in employed youth whereas the association between higher social support and lower stress levels was stronger in unemployed youth. Our findings provide insights on the differential associations of social and psychological resources with various facets of chronic stress in the context of employment and unemployment during adolescence.

Adolescence and Aging: Impact of Adolescence Inflammatory Stress and Microbiota Alterations on Brain Development, Aging, and Neurodegeneration

Puberty/adolescence is a critical phase during neurodevelopment with numerous structural, neurochemical, and molecular changes occurring in response to genetic and environmental signals. A consequence of this major neuronal reorganizing and remodeling is a heightened level of vulnerability to stressors and immune challenges. The gut microbiota is a fundamental modulator of stress and immune responses and has been found to play a role in mental health conditions and neurodegenerative disorders. Environmental insults (stress, infection, neuroinflammation, and use of antibiotics) during adolescence can result in dysbiosis subsidizing the development of brain disorders later in life. Also, pubertal neuroinflammatory insults can alter neurodevelopment, impact brain functioning in an enduring manner, and contribute to neurological disorders related to brain aging, such as Alzheimer's disease, Parkinson's disease, and depression. Exposure to probiotics during puberty can mitigate inflammation, reverse dysbiosis, and decrease vulnerabilities to brain disorders later in life. The goal of this review is to reveal the consequences of pubertal exposure to stress and immune challenges on the gut microbiota, immune reactivity within the brain, and the risk or resilience to stress-induced mental illnesses and neurodegenerative disorders. We propose that the consumption of probiotics during adolescence contribute to the prevention of brain pathologies in adulthood.

Daily parent-adolescent cortisol associations: Unpacking the direction of effects

Prior studies suggest bidirectional relationships between parent and adolescent behavior. This study examined how parents and their adolescent child's cortisol patterns are associated across days and if there are bidirectional associations between parent and child cortisol. Participants included two samples of employees and their children who participated in a daily diary study where diurnal salivary cortisol was collected on four study days (N = 318 dyads, Myouth age = 13.18 years, 52 % female). Autoregressive cross-lagged models were used to estimate parent-driven effects (parent cortisol effects on adolescent cortisol) and adolescent-driven effects (adolescent cortisol effects on parent cortisol). Adolescents' steeper cortisol awakening response (CAR) was significantly associated with parents' steeper CAR the following day. Adolescents' higher bedtime cortisol levels were also significantly associated with parents' higher bedtime cortisol levels the following day. Parents' cortisol did not predict their children's next-day cortisol. Results support a primarily adolescent-driven process of stress transmission in families. These results suggest that interventions to reduce adolescent stress, as well as to reduce parents' reactivity to adolescents, may be warranted.

A randomized controlled trial of a trauma-informed school prevention program for urban youth: Rationale, design, and methods

INTRODUCTION

Youth in disadvantaged urban areas are frequently exposed to chronic stress and trauma, including housing instability, neighborhood violence, and other poverty-related adversities. These exposures increase risk for emotional, behavioral, and academic problems and ultimately, school dropout. Schools are a promising setting in which to address these issues; however, there are few universal, trauma-informed school-based interventions for urban youth.

METHODS/DESIGN

Project POWER (Promoting Options for Wellness and Emotion Regulation) is a randomized controlled trial testing the impact of RAP Club, a trauma-informed intervention for eighth graders that includes mindfulness as a core component. Students in 32 urban public schools (n = 800) are randomly assigned to either RAP Club or a health education active control group. We assess student emotional, behavioral, and academic outcomes using self-report surveys and teacher ratings at baseline, post-intervention, and 4-month follow up. Focus groups and interviews with students, teachers, and principals address program feasibility, acceptability, and fidelity, as well as perceived program impacts. Students complete an additional self-report survey in ninth grade. Schools provide students' academic and disciplinary data for their seventh, eighth, and ninth grade years. In addition, data on program costs are collected to conduct an economic analysis of the intervention and active control programs.

DISCUSSION

Notable study features include program co-leadership by young adults from the community and building capacity of school personnel for continued program delivery. In addition to testing program impact, we will identify factors related to successful program implementation to inform future program use and dissemination.

Lasting Impact of Chronic Adolescent Stress and Glucocorticoid Receptor Selective Modulation in Male and Female Rats

Adolescent animals are vulnerable to the effects of stress on brain development. We hypothesized that long-term effects of adolescent chronic stress are mediated by glucocorticoid receptor (GR) signaling. We used a specific GR modulator (CORT108297) to pharmacologically disrupt GR signaling in adolescent rats during exposure to chronic variable stress (CVS). Male and female rats received 30 mg/kg of drug during a 2-week CVS protocol starting at PND46. Emotional reactivity (open field) and coping behaviors (forced swim test (FST)) were then tested in adulthood, 5 weeks after the end of the CVS protocol. Blood samples were collected two days before FST and serial samples after the onset of the swim test to determine baseline and stress response levels of HPA hormones respectively. Our results support differential behavioral, physiological and stress circuit reactivity to adolescent chronic stress exposure in males and females, with variable involvement of GR signaling. In response to adolescent stress, males had heightened reactivity to novelty and exhibited marked reduction in neuronal excitation following swim stress in adulthood, whereas females developed a passive coping strategy in the FST and enhanced HPA axis stress reactivity. Only the latter effect was attenuated by treatment with the GR modulator C108297. In summary, our data suggest that adolescent stress differentially affects emotional behavior and circuit development in males and females, and that GR manipulation during stress can reverse at least some of these effects.

Stressful Life Events in Different Social Contexts Are Associated With Self-Injury From Early Adolescence to Early Adulthood

Self-injury often arises as a maladaptive coping strategy used to alleviate distress. Past research has typically examined how chronic stressors in a specific context are associated with self-injury. Little is known about the unique and cumulative associations between acute stressful life events that occur in different social contexts and self-injury among adolescents. This is especially the case for males, for whom the etiology of self-injury is understudied. We examine the unique and cumulative contributions of stressful life events in the contexts of adolescents' school life, peer networks, intimate relationships, and family life to self-injurious behavior in males and females from the community. Our data comes from a prospective-longitudinal community-representative study, the Zurich Project on the Social Development from Childhood to Adulthood (z-proso). Our sample consists of 1,482 adolescents (52% male) assessed at ages 13, 15, 17, and 20. At each age, adolescents reported whether they had engaged in self-injury during the previous month. They also reported stressful life events in the school, peer, intimate relationships, and family contexts, typically since the last assessment. Stressful life events in the peer context were consistently associated with self-injury. In the contexts of school, intimate relationships, and family, some associations were age- or sex-specific. For example, mid-adolescent females were more likely than mid-adolescent males to use self-injury when faced with stressful events in school and intimate relationships. With respect to risk accumulation, females' risk of self-injury increased with each additional life event between the ages of 13 and 17, beginning at 2+ events. This pattern did not hold for males. In early adulthood, 4+ life events were associated with an increased risk of self-injury, which suggests that the thresholds for the number of life events needed to trigger self-injury increased from adolescence to young adulthood. Our findings suggest that reducing risk of stressful events in different social contexts, and improving young people's coping skills could help reduce their risk of self-injury. New or revised theoretical models may be needed to better understand the emergence of self-injury in males.

Magical Potential: Why Magic Performances Should be Used to Explore the Psychological Factors Contributing to Human Belief Formation

Beliefs in supernatural entities are integral parts of both our culturally embedded religions and more individualized magical belief systems (e.g., paranormal beliefs, spirituality). Scholars regularly link the occurrence of beliefs to individuals' cognitive and affective ways of information processing. For magical beliefs in particular, we expect children to endorse them. When reaching adulthood, however, individuals should have abandoned magical beliefs, and become pragmatic, sceptical, critical and rational thinkers. The reality is, a large proportion of the adult population can be described as magical thinkers, or report having had magical experiences, even in the recent past. Moreover, psychological research in adults shows a large range of magical beliefs, which correlate with particular psychological processing biases (e.g., repetition avoidance, seeing signal in noise). Unfortunately, these correlational studies do not tell us whether such psychological processing biases precede magical beliefs or whether they result from these magical beliefs. Knowing the direction of such relationships is key to understand which psychological biases might contribute to adult belief formation (or the persistence of beliefs from childhood). To test such causal relationships, we started to systematically apply an experimental approach in which people are exposed to anomalous events. Such a central event allows before-after comparisons of psychological biases. First empirical results confirmed that the use of magic performances, particularly when of paranormal nature, results in an important amount of paranormal explanations. Pre-existing beliefs enhanced this explanation bias. These results show how easily naïve observers can be "tricked" into unsubstantiated beliefs.

Co-activation of SAM and HPA responses to acute stress: A review of the literature and test of differential associations with preadolescents' internalizing and externalizing

Understanding co-activation patterns of the hypothalamic-pituitary-adrenal axis (HPA) and sympathetic adrenal medullary (SAM) during early adolescence may illuminate risk for development of internalizing and externalizing problems. The present study advances empirical work on the topic by examining SAM-HPA co-activation during both the reactivity and recovery phases of the stress response following acute stress exposure. Fourth and fifth grade boys and girls (N = 149) provided cortisol and alpha-amylase via saliva at seven times throughout a 95-min assessment in which they were administered the modified Trier Social Stress Test. Parents reported on adolescents' life stress, pubertal development, medication use, and externalizing problems. Adolescents reported their own internalizing symptoms. Multiple linear regressions tested both direct and interactive effects of SAM and HPA reactivity and recovery on internalizing and externalizing problems. Results from these analyses showed that whereas SAM and HPA reactivity interacted to predict internalizing symptoms, it was their interaction during the recovery phase that predicted externalizing. Concurrent high SAM and HPA reactivity scores predicted high levels of internalizing and concurrently low SAM and HPA recovery scores predicted high levels of externalizing. Implications of the findings for further study and clinical application are discussed.

Voluntary Wheel Running Exercise Evoked by Food-Restriction Stress Exacerbates Weight Loss of Adolescent Female Rats But Also Promotes Resilience by Enhancing GABAergic Inhibition of Pyramidal Neurons in the Dorsal Hippocampus

Adolescence is marked by increased vulnerability to mental disorders and maladaptive behaviors, including anorexia nervosa. Food-restriction (FR) stress evokes foraging, which translates to increased wheel running exercise (EX) for caged rodents, a maladaptive behavior, since it does not improve food access and exacerbates weight loss. While almost all adolescent rodents increase EX following FR, some then become resilient by suppressing EX by the second-fourth FR day, which minimizes weight loss. We asked whether GABAergic plasticity in the hippocampus may underlie this gain in resilience. In vitro slice physiology revealed doubling of pyramidal neurons' GABA response in the dorsal hippocampus of food-restricted animals with wheel access (FR + EX for 4 days), but without increase of mIPSC amplitudes. mIPSC frequency increased by 46%, but electron microscopy revealed no increase in axosomatic GABAergic synapse number onto pyramidal cells and only a modest increase (26%) of GABAergic synapse lengths. These changes suggest increase of vesicular release probability and extrasynaptic GABAA receptors and unsilencing of GABAergic synapses. GABAergic synapse lengths correlated with individual's suppression of wheel running and weight loss. These analyses indicate that EX can have dual roles-exacerbate weight loss but also promote resilience to some by dampening hippocampal excitability.

Extending the toxic stress model into adolescence: Profiles of cortisol reactivity

The toxic stress model posits that extended activation of stress response systems in the absence of a supportive relationship with an adult may over time lead to physiological alterations to these same systems, and ultimately to poorer physical and mental health outcomes. However, empirical tests of model hypotheses in adolescence, a critical period of development, are lacking. This study expands the toxic stress model to include more developmentally-appropriate risk and protective factors for adolescents experiencing overwhelming and uncontrollable stressors. Data were collected for a study of early adolescents from urban low-income households (N = 101; 10-12 years old; 59% female). Participants and a caregiver completed questionnaires; youths completed the modified Trier Social Stress Task alone and provided six saliva samples. Using latent profile analysis, three profiles of cortisol reactivity were identified in early adolescents exposed to chronic environmental stress: Elevated and Reactive (11%), Moderate and Non-Reactive (26%), and Blunted and Non-Reactive (63%). In accordance with the toxic stress model, exposure to more community violence and less family support were associated with blunted cortisol reactivity, and Reactive profile membership was associated with fewer trauma symptoms. Overall, the findings provide empirical support for the extension of the toxic stress model in early adolescence through the application of developmentally-sensitive measures and provide implications for future interventions.