Peer experiences of anxious and socially withdrawn youth: an integrative review of the developmental and clinical literature

Examining the interrelationships of school connectedness, social anxiety, and problematic social network use in adolescents

INTRODUCTION

While social networks have become an integral part of people's lives, they also bring the potential for negative consequences, with problematic social network use emerging as a noteworthy concern, especially among adolescents. Guided by social control theory, this study examined bidirectional relationships between problematic social network use and its influencing factors: school connectedness and social anxiety.

METHODS

Random intercept cross-lagged panel models were employed to examine the bidirectional relationships among school connectedness, social anxiety, and problematic social network use. Data were collected using the School Connectedness Scale, the Social Interaction Anxiety Scale, and the Evaluation Tool for Problematic Mobile Social Network Usage. Measurements were taken at three different times, each 6 months apart, over the course of 1 year (Time 1-3; T1 in November 2020). A total of 1684 Chinese adolescents (45.23% boys, Mage = 14.66, SD = 1.30) from a secondary school in Chaozhou City, Guangdong Province, China, participated in the study.

RESULTS

The results indicated school connectedness and problematic social network use negatively predicted each other over time. In contrast, a positive bidirectional relationship was found between social anxiety and problematic social network use.

CONCLUSIONS

The findings have important implications for the development of targeted intervention strategies aimed at promoting healthy online habits and preventing the escalation of problematic social network use among adolescents. By highlighting the dynamic interplay between school connectedness, social anxiety, and social network use, this study contributes to a deeper understanding of these issues and lays the groundwork for future research and interventions aimed at supporting adolescents in navigating the digital landscape.

Interpersonal synchronization: An overlooked factor in development, social cognition, and psychopathology

Intact social functioning relies on a combination of explicit and implicit behavioral, attentional, and interpersonal processes referred to as "social cognition". Characterizing these interpersonal processes forms a critical underpinning to understanding and treating psychopathology, particularly in disorders where deficits in social functioning do not emerge as a secondary symptom but rather as an essential feature of the disorder. Two of such disorders are autism spectrum disorders (ASD) and schizophrenia spectrum disorders (SZ). However, despite the substantial overlap in the features of social dysfunction between ASD and SZ, including social cognitive deficits in theory of mind, perspective-taking, and empathy, there is a limited understanding of the mechanisms underlying those shared deficits, and how to treat them. We suggest that disruptions of interpersonal functioning emerge over the course of development, and that interpersonal synchronization, a phenomenon in which behavioral and physiological cues align between interacting partners, forms a critical component of social cognition that underlies the disruption in social functioning in ASD and SZ. We present a conceptual review of typical and atypical development of social processes and highlight the role of interpersonal synchronization across the course of development. Then, we review the existing evidence suggesting impairments in both the intentional and spontaneous synchronization of interpersonal processes in ASD and SZ, as well as studies suggesting that interpersonal synchronization and clinical symptoms may be improved through body-oriented interventions within these disorders. Finally, we suggest potential mechanisms that may underpin typical and atypical development of interpersonal synchronization.

Examining longitudinal associations between interpersonal outcomes and general psychopathology factors across preadolescence using random intercept cross-lagged panel model

BACKGROUND

Interpersonal outcomes and mental health problems are closely associated. However, their reciprocal influence has not been directly examined while considering the temporal stability of these constructs, as well as shared and unique variance associated with internalising, externalising and attention problems. Using random intercept cross-lagged panel models (RI-CLPM), we tested the hypotheses that negative bidirectional associations at the between-person and negative cross-lagged effects at the within-person level would emerge between interpersonal outcomes (friendship quality and perceived popularity) and mental health problems (i.e. general psychopathology factor) during preadolescence.

METHODS

Participants (n = 918) were from the NICHD Study of Early Child Care and Youth Development. Psychopathology, consisting of a general psychopathology factor (p-factor) and three specific factors (internalising, externalising and attention problems), was derived from mother-reported Child Behaviour Checklist symptoms. Friendship quality was assessed using the self-reported Friendship Quality Questionnaire. Popularity was assessed using teacher-reported popularity ranking. Four RI-CLPM were estimated to examine the associations between interpersonal outcomes and psychopathology at between- and within-person levels across four timepoints (mean ages 8-11).

RESULTS

At the between-person level, popularity scores, but not friendship quality, were negatively associated with p-factor scores (β = -.33). At the within-person level, we found (i) p-factor scores at age 9 negatively predicted friendship quality and popularity at age 10, but not at other ages (β = -.16 to -.19); (ii) specific externalising factor scores at age 10 negatively predicted friendship quality at age 11 (β = -.10) and specific internalising factor scores at ages 8 and 9 positively predicted friendship quality at ages 9 and 10 (β = .09-.12) and (iii) popularity at age 10 negatively predicted specific internalising factor scores at age 11 (β = -.12).

CONCLUSIONS

Psychopathology was found to influence interpersonal outcomes during preadolescence, while the reverse effects were less readily observed, once between-person level effects were accounted for.

The Relation Between Social Anxiety and Perceptions of Likeability and Friendship in Adolescents

Background

This study investigated how different social anxiety symptoms (i.e., worrying about negative evaluation versus avoidance tendencies) in adolescents are related to the perception accuracy of likeability by peers and friendships with peers.

Method

A community sample of 263 adolescents between 12 and 15 years old reported on their social anxiety symptoms. In addition, they estimated how much their peers liked them, indicated how much they liked their peers, and who their friends were in their classroom.

Results

Results showed that socially anxious adolescents who mainly worried about negative evaluations, underestimated their likeability by peers. Adolescents with strong social avoidance tendencies had a more accurate perception of their likeability and friendships; they were less liked by their peers and had fewer friends.

Conclusion

The results emphasize the importance of treating avoidance behavior in social anxiety since avoidance tendencies may not only maintain the social anxiety symptoms but are also related to a more negative judgment by others.

Testing theoretical processes that maintain paediatric social anxiety: A comparison between children and adolescents with social anxiety disorder, other mental disorders, and non-clinical controls

BACKGROUND

Paediatric social anxiety disorder (SoAD) responds poorly to treatment. Improved understanding of potential psychological maintaining processes may indicate fruitful directions to improve treatment outcomes. The current study compared self-reported psychological processes and state anxiety in response to two social tasks experienced by children and adolescents with SoAD against comparison samples.

METHODS

641 children and adolescents aged 6-17 years (Mage = 9.45 yr; 47.6% girls) engaged in a brief, impromptu speech and a social discussion with a confederate. Participants included 307 with SoAD, 285 with other mental disorders, and 49 non-clinical controls. Participants who completed each task self-reported their anticipated probability and cost of negative evaluation, self-focused attention, personal evaluation of social performance, and engagement in post-event rumination (assessed 1 h later). Independent raters also scored their social performance. Relationships between the variables were tested through path analysis.

RESULTS

Participants with SoAD were more likely to avoid and reported significantly greater state anxiety than both comparison groups. They also reported higher levels of each of the putative maintaining processes than either comparison group. In contrast, independent observers did not discriminate between groups on their overt social performance. Path analyses demonstrated good fit of a priori models to the data for both social tasks.

CONCLUSIONS

Paediatric SoAD is associated with strong expectation of the probability and cost of negative evaluation, excess self-focused attention, and more negative evaluation of one's own social performance. In turn, these putative processes are strong predictors of state anxiety and post-event processing in response to both a speech and social interaction.

The impact of co-occurring chronic pain and mental health symptoms on adolescent functioning, a cross-sectional survey

Adolescents who experience poor mental health may develop chronic pain. Similarly, those with chronic pain may develop mental health symptoms. Little is known concerning how these co-occurring symptoms are associated with adolescent functioning. Our online cross-sectional quantitative study compared the specific nature of challenges to psychosocial functioning, across 4 groups: (1) adolescents with co-occurring chronic pain and mental health symptoms; (2) adolescents who only experience chronic pain symptoms; (3) adolescents who only experience mental health symptoms, and (4) adolescents who do not report either symptom. Participants completed self-report questionnaires assessing pain experiences, mental health symptoms and psychosocial functioning. After controlling for pain intensity, findings revealed significant differences, in physical, social, and family functioning across all groups. Significantly worse physical functioning was reported by adolescents with co-occurring pain and mental health symptoms and those with pain-only symptoms compared with adolescents with mental health-only symptoms and those without symptoms. Social functioning was significantly worse for adolescents who experienced co-occurring chronic pain and mental health symptoms compared with adolescents who experienced pain-only symptoms, and those with no symptoms. Significantly worse family functioning was reported by adolescents with mental health-only symptoms compared with adolescents reporting pain-only symptoms and no symptoms. Results suggest the combined impact of pain and mental health symptoms mainly influences adolescent social functioning. Future research is needed to develop standardised assessment and treatment plans to facilitate a thorough understanding of symptoms presented by adolescents who experience co-occurring pain and mental health symptoms.This study identifies that the combined impact of pain and mental health symptoms influences adolescent social functioning when compared to adolescents who experience pain-only or those without symptoms. Research is needed to develop standardised assessment and treatment plans to fully understand the symptoms presented by adolescents with co-occurring symptoms.

The longitudinal relationship between loneliness and both social anxiety and mobile phone addiction among rural left-behind children: A cross-lagged panel analysis

INTRODUCTION

Left-behind children are a special group that needs urgent attention. Due to enduring separation from their parents, loneliness is considered the most common and prevalent developmental hurdle in the experiences of left-behind children. This longitudinal cross-lagged study examined the direction of the association between loneliness and both internalizing and externalizing symptoms, with considering gender and left-behind status differences.

METHODS

A total of 1175 rural Chinese children (48.3% boys, 39.9% left-behind children, Mage = 14.54 ± 1.18 at baseline) completed self-reported loneliness, social anxiety, and mobile phone addiction at two-time points with 6 months intervals. Descriptive statistics, cross-lagged panel analysis, and multiple group analysis were estimated in the present study.

RESULTS

Loneliness exacerbated social anxiety and mobile phone addiction, and vice versa. In addition, gender and left-behind status moderated these relationships, with boys more likely to be mobile phone addicted due to loneliness and girls more likely to be lonely due to mobile phone addiction. More importantly, left-behind children with loneliness are more prone to social anxiety and mobile phone addiction, and vice versa, compared with non-left-behind children.

CONCLUSIONS

The targeted interventions should be carried out for different genders and left-behind statuses. Particularly for left-behind children, neglecting to address both the symptoms of loneliness and both social anxiety and mobile phone addiction could significantly undermine the efficacy of intervention programs that solely target either one of these afflictions.

Social Anxiety and Bullying Victimization in Children and Early Adolescents: The Role of Developmental Period and Immigrant Status

Research reveals that social anxiety may be predictive of bullying victimization, but it is not clear whether this relation stands for different groups of youth. The present study examines this association by employing a longitudinal design over 1 year and including the moderating role of developmental period (childhood vs. early adolescence) and students' immigrant status (native vs. non-native). T1 sample included 506 children (46.44% girls, mean age M = 8.55 years, SD = 0.55) and 310 early adolescents (50% girls, mean age = 12.54 years, SD = 0.59) recruited in schools in Northern Italy. Due to missing cases and drop-outs from T1 to T2, the final sample comprised 443 and 203 students from primary and middle school, respectively. Social anxiety and peer victimization were assessed through self-reported questionnaires. Results indicated that victimization at T2 was predicted by a 3-way interaction between T1 social anxiety, immigrant status, and developmental period. In particular, socially anxious early adolescents with an immigrant background were the most victimized. The results are discussed in terms of group dynamics and intergroup processes. The findings highlight the importance of personal variables in the cumulation of risks: social anxiety is more predictive of bullying victimization for immigrant early adolescents than for children or native early adolescents.

Social Anxiety Disorder: Associations with Peer-Liking, Discrimination, and Prejudicial Feelings in Early Adolescent Girls

Social anxiety can have an adverse effect on social connections, educational achievement, and wellbeing. However, the extent to which students stigmatize their peers with social anxiety disorder (SAD) in female educational settings remains unknown. This study investigated the relationship between SAD, peer-liking and stigma in a cohort of early adolescent girls. The sample was 103 sixth and seventh graders attending three girls' schools in Australia. The students, aged between 10- and 13-years, were randomly allocated to either a control (n = 52) or experimental (n = 51) group. Participants completed an online survey while at school to examine their responses to one of two age-and-gender matched vignettes: a hypothetical peer with SAD (experimental condition), or without SAD (control condition). Contrary to expectations, group comparisons revealed that students with the SAD vignette liked their peer more than students with the non-SAD vignette. Also, students endorsed higher levels of pity, lower levels of fear, but similar levels of anger when considering their SAD (versus non-SAD) peer. In the SAD group, higher levels of pity were associated with greater peer-liking. The opposite pattern was evident in response to the non-SAD peer. Importantly, students discriminated less (preferred less social distance) in response to their peer with SAD. This points to the potential benefit of adolescent peer programs that aim to promote positive peer-relationships as a protective factor for students with SAD. Future research may examine gender and socio-economically diverse students to increase the confidence with which findings can be generalized to other educational settings.

Social media behaviors and symptoms of anxiety and depression. A four-wave cohort study from age 10-16 years

Background

Concerns have been raised that social media use causes mental health problems in adolescents, but findings are mixed, and effects are typically small. The present inquiry is the first to measure diagnostically-defined symptoms of depression and anxiety, examining whether changes in social media behavior predict changes in levels of symptoms from age 10 to 16, and vice versa. We differentiate between activity related to one's own vs. others' social media content or pages (i.e., self-oriented: posting updates, photos vs other-oriented: liking, commenting).

Methods

A birth-cohort of Norwegian children was interviewed about their social media at ages 10, 12, 14 and 16 years (n = 810). Symptoms of depression, social anxiety and generalized anxiety were captured by psychiatric interviews and data was analyzed using Random Intercept Cross-lagged Panel Modeling.

Results

Within-person changes in self- and other oriented social media behavior were unrelated to within-person changes in symptoms of depression or anxiety two years later, and vice versa. This null finding was evident across all timepoints and for both sexes.

Conclusions

The frequency of posting, liking, and commenting is unrelated to future symptoms of depression and anxiety. This is true also when gold standard measures of depression and anxiety are applied.

Comorbidity of loneliness and social anxiety in adolescents: Bridge symptoms and peer relationships

RATIONALE

Previous research investigating the comorbidity of loneliness and social anxiety symptoms in population samples has relied on latent variable modeling in which averaged scores representing dimensions were derived from observed symptoms. Studies have not examined how loneliness and social anxiety co-occur at the symptom level or their relations with peer relationships.

OBJECTIVE

This study examined the comorbidity of loneliness and social anxiety and the role of peer relationships (i.e., the number of reciprocated friends, friendship quality, and bullying victimization) in adolescents' co-occurring network using a large sample of Chinese adolescents.

METHODS

We performed a network analysis in a sample of Chinese adolescents (N = 2601, 51.6% male, M age = 13.9 years, SD = 0.60). Participants completed self-report measures of loneliness, social anxiety, bullying victimization, and friendship quality as well as peer nomination measures of the number of reciprocated friends.

RESULTS

Network analysis revealed that feeling ridiculed, fear of being rejected, having difficulty asking others to do things together, and feeling left out at school were essential bridge symptoms in the co-occurrence of loneliness and social anxiety. Bullying victimization had more positive associations with symptoms of social anxiety, and friendship quality had more negative associations with symptoms of loneliness.

CONCLUSIONS

The findings provide preliminary evidence for the comorbidity of loneliness and social anxiety symptoms in adolescents. The results also highlight the potential importance of targeting peer relationships in the prevention and intervention of loneliness and social anxiety symptoms. The combination of longitudinal networks and interventions on bridge symptoms may provide further insight into the development of the links between peer relationships, loneliness, and social anxiety symptoms.

Anxiety disorders in children and adolescents: A summary and overview of the literature

Considerable work has advanced understanding of the nature, causes, management, and prevention of anxiety disorders in children and adolescents over the past 30 years. Prior to this time the primary focus was on school refusal and specific phobias. It is now recognised that children and adolescents experience the full gamut of anxiety disorders in very similar ways to adults and that anxiety disorders in the paediatric years can predict a lifelong mental-health struggle. Given the vast array of specific studies in this field, the current review summarises current knowledge about these high prevalence disorders, points to overarching limitations, and suggests potentially important future directions. Following a brief historical overview, the review summarises knowledge about demographic and epidemiological characteristics, distal and proximal risk factors, current treatment directions, and prevention. There is still a great deal to learn about the causes and treatments of child and adolescent anxiety disorders. By amalgamating our current knowledge, this review provides a window to the research directions that are likely to lead to future advances.

Self-Compassion and Anxiety in Adolescents with and without Anxiety Disorder

Previous studies have linked self-compassion to mental health, specifically anxiety, in non-clinical adolescents, suggesting that self-compassion can be a protective factor against anxiety. This study compared the overall level of self-compassion and (un)compassionate self-responding in adolescents with and without an anxiety disorder and assessed the association between self-compassion and anxiety. This cross-sectional study included adolescents (12-19 years) with an anxiety disorder (N = 23) and a reference group (N = 28). Participants completed the Self-Compassion Scale (SCS) and State Trait Anxiety Inventory (STAI). Results showed that overall self-compassion and uncompassionate self-responding were significantly lower and higher in the clinical than the reference group, respectively, while compassionate self-responding did not differ between groups. In the clinical group, only uncompassionate self-responding was significantly associated with higher anxiety. In the reference group, uncompassionate self-responding showed a significant positive association with anxiety, and compassionate self-responding showed a significant negative association with anxiety. Although the results suggest that low uncompassionate self-responding may buffer against anxiety, the role of compassionate and uncompassionate self-responding remains unclear. An alternative explanation is that the uncompassionate self-responding items measure the presence of psychopathology in adolescents with an anxiety disorder. More research on the construct validity of the SCS uncompassionate self-responding scale is needed.

Why worry with friends? Problem talk and anxiety in late adolescent friendships

INTRODUCTION

This study investigated a theoretically derived peer conversation style, problem anxiety talk, to examine the emotional regulation of anxiety in dyads as a possible mechanism of anxiety contagion that occurs between adolescent friends.

METHODS

In Study 1, 376 late adolescents residing in the United States, ages 17-24 with 68% female, responded to measures of anxiety, worry, friendship quality, depression, co-rumination, and a new measure of problem anxiety talk. In Study 2 problem anxiety talk, stress, anxiety and depression were evaluated in 481 late adolescents, ages 17-24 with 64% female.

RESULTS

Once controlling for worry and co-rumination, problem anxiety talk with a close friend predicted anxiety, stress and depression for both samples of late adolescents. Factor analysis in each sample supported problem anxiety talk as a single factor with high internal consistency.

CONCLUSIONS

Findings indicate that problem anxiety talk is a distinct construct representing interpersonal disclosures between friends involving threat perception, likelihood of negative events, and lack of coping skills; results also indicate that problem anxiety talk is associated with anxiety, stress, worry, and depression. Implications of problem anxiety talk in its potential role in the etiology and spread of anxiety are discussed.

Cognitive Disengagement Syndrome (Sluggish Cognitive Tempo) and Social Withdrawal: Advancing a Conceptual Model to Guide Future Research

OBJECTIVE

Cognitive disengagement syndrome (CDS, previously referred to as "sluggish cognitive tempo") is a set of symptoms defined by excessive mind-wandering, mental confusion, and slowed behaviors separable from ADHD inattention.

METHOD

Of the studies examining CDS in relation to psychosocial outcomes, one of the most established correlates of CDS is social withdrawal. However, studies have yet to test mechanisms or moderators of the link between CDS and social withdrawal.

RESULTS

As a parallel body of literature exists in developmental psychopathology on predictors and outcomes of social withdrawal, this review merges these literatures to identify themes and advance a conceptual model on mechanisms (e.g., task-unrelated thought, poorer social skills, social anxiety) and moderators (e.g., behavioral inhibition, sex, parenting) of the CDS and social withdrawal link.

CONCLUSION

This model provides researchers and clinicians with testable hypotheses to better understand the link between CDS and social withdrawal and to identify treatment targets to improve the social engagement of youth with CDS.

Perceived teacher support, peer relationship, and university students' mental health: The mediation of reality and Internet altruistic behaviors

Studying in universities is a crucial development stage for students, whose thoughts, feelings, and actions are affected by interactions with their teachers and peers. This study explored the relationships between perceived teacher support and mental health as well as those between peer relationship and mental health among university students, and examined the mediating effects of reality and Internet altruistic behaviors on these relationships. Perceived teacher support questionnaire, peer relationship satisfaction questionnaire, self-reported altruism questionnaire, Internet altruistic behavior questionnaire, and general health questionnaire were administered to 553 university students. Results demonstrated that perceived teacher support and peer relationship positively predicted reality and Internet altruistic behaviors and positively predicted mental health. Reality and Internet altruistic behaviors positively predicted mental health and exerted significant mediating effects on the correlations between perceived teacher support and mental health as well as those between peer relationship and mental health. The male and female students differed insignificantly in the mediating effects of reality and Internet altruistic behaviors. Therefore, no matter for males or females, teachers should provide sufficient support for the students and establish favorable relationships with them. Friendly relationships, comfort, and active communication among peer students are also essential for creating a healthy and harmonious interaction environment. Those various factors of the school have impacts on the mental health of university students through their altruistic behaviors. This study suggests that further emphasis on teacher support and peer relationship is needed to promote the positive development of altruistic behaviors among university students, and ultimately provide a viable contribution to the university students' mental health interventions.

Symptom association between social anxiety disorder, appearance anxiety, and eating disorders among Chinese University students: A network analysis to conceptualize comorbidity

Background

Incidences of social anxiety disorder (SAD), appearance anxiety, and eating disorders (ED) show an increased prevalence among young people. However, symptoms' associations between these disorders have not been investigated in depth. Network analysis is an approach that can be used to explain the relationship(s) between symptoms of different psychological disorders. Using network analysis, this study aimed to explore the association and potential interacting mechanisms between SAD, appearance anxiety, and ED.

Methods

This study included 96,218 University students from Jilin Province, China. SAD, appearance anxiety and ED were assessed using the Social Anxiety Subscale of the Self-Consciousness Scale (SASS), the Appearance Anxiety Scale Brief Version (AASBV), and the Sick, Control, One, Fat, Food questionnaire (SCOFF), Chinese versions. Network analysis was employed to investigate the symptom associations, while the stability of the network model was analyzed using statistical measures.

Results

The prevalence of ED among the total sample was 38% (95% CI: 38.1-38.8%), while this figure was 31.2% (95% CI: 30.7-31.6%) in males and 43.6% (95% CI: 43.2-44.0%) in females. Additionally, the total score of SAD was significantly higher in females (11.83 ± 5.37) than it in males (10.02 ± 5.46) (P < 0.001). While the total score of appearance anxiety was also different significantly in gender (39.21 ± 9.49 in females vs. 38 ± 9.42 in males) (P < 0.001). Results showed that ED was associated with all three aspects of appearance anxiety, including "appearance concern," "appearance satisfaction," and "wish for good looks." Appearance anxiety and SAD were also associated; specifically, symptoms of "appearance satisfaction" were significantly associated with the symptoms "easily talk to strangers" and "appearance concern", which was also significantly associated with "embarrassed". Compared with males, females showed significantly stronger associations with appearance anxiety symptoms, while ED symptoms were associated with "troubled by being watched" and "appearance concern".

Conclusion

Appearance anxiety was associated with both ED and SAD symptoms. ED may have a potential relationship with SAD, affecting appearance anxiety indirectly. Significant differences were found among males and females in symptom associations between appearance anxiety and SAD. This study therefore clarified that young people should have body-positive interventions and challenge the normative body image discourse, which may help alleviate symptoms of SAD and ED.

РОЛЬ СОЦІАЛЬНОГО ВІДСТОРОНЕННЯ ТА ВІДКИНЕННЯ У ПАТОГЕНЕЗІ СОЦІАЛЬНОГО ТРИВОЖНОГО РОЗЛАДУ: ОГЛЯД ЗАКОРДОННОЇ ЛІТЕРАТУРИ

Мета: теоретично  проаналізувати роль соціального відсторонення та відкинення у патогенезі соціального тривожного розладу як модифікуючих факторів вразливості. Методи. Пошук попередніх досліджень здійснювався за допомогою сервісів  PubMed, Web-of-Science та Research Gate за наступними критеріями: дослідження стосувалися осіб, які мали встановлений діагноз соціальний тривожний розлад або належали до субклінічної групи; була проведена первинна оцінка чи аналіз впливу соціального відсторонення та відкинення; фокусом уваги досліджень соціальна фобія та/чи соціальне відсторонення/відкинення. Результати. Опрацьовуючи дану проблематику було проаналізовано понад 214 наукових статей, з яких  переважна частина опубліковані після 2017 року. У відповідності до критеріїв було обрано 30 статей. За результатами аналізу даних встановлено, що засвоєння соціального травматичного досвіду та підвищений рівень нейротизму сприяють формуванню непродуктивних когнітивних стратегій оцінювання («передбачення катастрофи») соціальних ситуацій й себе в них та відповідних їх змісту поведінкових стратегій уникнення через страх соціального відкинення, що безпосередньо знижує соціальну ефективність особи. Недостатня усвідомленість власних емоцій та викривлені переконання навколо них, стимулюючи уникнення й соціальне відсторонення як запобіжний засіб, обумовлюють високі показники соціальної тривожності, посилюють сприйняття соціальної загрози й зменшують сприйняття контролю над нею, та як наслідок актуалізують патерни травматичного досвіду, який особа намагалася уникнути. Опанування суб’єктивного емоційного досвіду за умов обмежених ресурсів життєвих обставин (як пандемія, проблемні стосунки, тривала ситуація невизначеності тощо) підсилюють вразливість до соціального тривожного розладу як непродуктивної копінг стратегії. Висновки. Уникнення емоційного досвіду та підтримання не коригуючого досвіду стосунків через страх бути відкинутим може закріплювати дисфункційний цикл когнітивних переконань щодо себе й світу у патогенезі соціальної фобії й знаходити свій прояв у соціальній відстороненості.  Ключові слова: уникаюча поведінка, соціальна травма, ранні дисфункційні схеми, стигма, COVID-19.

Impact of Psychotherapy for Children and Adolescents with Anxiety Disorders on Global and Domain-Specific Functioning: A Systematic Review and Meta-analysis

A substantial empirical base supports the use of psychotherapy to alleviate anxiety symptoms and diagnoses in children and adolescents. However, focusing only on symptom or diagnostic reduction provides an incomplete picture of clinically meaningful efficacy given that anxiety disorders in this age group are integrally associated with problems in functioning. A systematic review and meta-analysis (N studies = 40, N participants = 3094) evaluating the impacts of psychotherapy for anxiety was conducted on the following outcomes: global functioning, social functioning, academic functioning, and school attendance. Randomised controlled trials with a passive control condition, a child and/or adolescent sample (7-17 years) with a primary anxiety diagnosis, and receiving anxiety-focused psychotherapy were eligible for inclusion if they reported suitable outcome data. Results from the meta-analysis indicated that from pre- to post-treatment, psychotherapy led to significant improvements in global functioning according to clinician (d = 1.55), parent (d = 0.67), and child (d = 0.31) reports and on social functioning according to parent (d = 0.51), but not child (d = 0.31) reports. The qualitative review provided preliminary support psychotherapy's efficacy in increasing family functioning and school attendance, but not so much in enhancing academic performance. These results indicate that psychotherapy improves daily functioning in anxious children and adolescents. The study also highlighted the limited attention paid to measures of functioning in the empirical literature on treatment of childhood anxiety.Trial Registry: This study is registered with PROSPERO under the identification number CRD42021246565.

Peer Status as a Potential Risk or Protective Factor: A Latent Profile Analysis on Peer Status and Its Association with Internalizing Symptoms in Adolescents with and without Parental Physical Abuse Experience

Research has well established that parental physical abuse experiences can lead to devastating consequences for adolescents, with peer relationships acting as both protective and risk factors. With the person-centered latent profile analysis (LPA), we analyzed questionnaire data from a cross-sectional study in 2020 composed of a sample of 1959 seventh-grade high school students from Switzerland. This study investigated and compared peer-status profiles combining peer acceptance and peer popularity for adolescents with and without parental physical abuse experiences. We conducted a multinomial logistic regression analysis to investigate further depression, anxiety, and dissociation as predictors of profile membership. With LPA, we identified three distinct profiles for adolescents within the subgroup with experiences of parental physical abuse (n = 344), namely liked, liked-popular, and rejected-unpopular. Within the subgroup of adolescents without parental physical abuse experiences (n = 1565), LPA revealed four profiles, namely liked, liked-popular, rejected-unpopular, and average. For adolescents with parental physical abuse experiences, higher levels of dissociation significantly indicated they were more likely to belong to the rejected-unpopular group than belong to the liked group. Anxious students without experiences of parental physical abuse were more likely to belong to the rejected-unpopular and liked profiles than belong to the liked-popular and average profiles. These findings clearly argue for a deeper understanding of the role of parental physical abuse when analyzing the relationship between dissociation and anxiety and peer status. Operationalizing peer status with the four individual dimensions of likeability, rejection, popularity, and unpopularity was valuable in that the role of peer rejection with respect to different internalizing symptoms became apparent.

Under the Surface: The Role of Covert Cues in Peer Suicide Risk Referrals

Suicidal thoughts and behaviors are highly prevalent among adolescents, and peers are often the first, and sometimes only, people to know about youth suicidality. Since many adolescents do not directly disclose suicidal thoughts, school-based suicide prevention programs aim to train youth to recognize warning signs of suicide in their peers that serve as "cues" to refer at-risk peers to an appropriate adult. However, peer-presented cues vary widely in presentation, and adolescents are more likely to recognize overt (i.e., obvious or explicit) as opposed to covert (i.e., hidden or implied) cues. The type of cue exhibited may, in turn, affect whether adolescents make a referral to an adult. The current study examined whether training suicide prevention influences referral intentions for overt and covert suicide cues. Participants included 244 high school students (54% female; M _age = 16.21) in the Southeastern United States who received suicide prevention training (SOS; Signs of Suicide) as part of their health curriculum. Prior to training, students endorsed higher referral intentions for peers exhibiting overt compared to covert cues. Training was associated with increased intentions to refer peers across cue type, but referral intentions for covert cues improved significantly from pre to post-training while those for overt cues remained high and stable. Findings suggest that suicide prevention training might differentially improve students' ability to detect and respond appropriately to less obvious indicators of suicide risk. These findings may inform the adaptation and development of future, more nuanced school-based suicide prevention programming.

Quality over quantity: A transactional model of social withdrawal and friendship development in late adolescence

The aim of this study was to test a longitudinal, transactional model that describes how social withdrawal and friendship development are interrelated in late adolescence, and to investigate if post-secondary transitions are catalysts of change for highly withdrawn adolescents' friendships. Unilateral friendship data of 1,019 adolescents (61.3% female, 91% Dutch-origin) from the Tracking Adolescents' Individual Lives Survey (TRAILS) cohort were collected five times from ages 17 to 18 years. Social withdrawal was assessed at 16 and 19 years. The transactional model was tested within a Structural Equation Modeling framework, with intercepts and slopes of friendship quantity, quality, and stability as mediators and residential transitions, education transitions, and sex as moderators. The results confirmed the presence of a transactional relation between withdrawal and friendship quality. Whereas higher age 16 withdrawal predicted having fewer, lower-quality, and less-stable friendships, only having lower-quality friendships, in turn, predicted higher age 19 withdrawal, especially in girls. Residential transitions were catalysts of change for highly withdrawn youth's number of friends: higher withdrawal predicted a moderate increase in number of friends for adolescents who relocated, and no change for those who made an educational transition or did not transition. Taken together, these results indicate that the quality of friendships-over and above number of friends and the stability of those friendships-is particularly important for entrenching or diminishing withdrawal in late adolescence, and that relocating provides an opportunity for withdrawn late adolescents to expand their friendship networks.

Neural Responses to Social Reward Predict Depressive Symptoms in Adolescent Girls During the COVID-19 Pandemic

OBJECTIVE

Adolescent depression is increasing during the COVID-19 pandemic, possibly related to dramatic social changes. Individual-level factors that contribute to social functioning, such as temperament and neural reactivity to social feedback, may confer risk for or resilience against depressive symptoms during the pandemic.

METHODS

Ninety-three girls (12-17 years) oversampled for high shy/fearful temperament were recruited from a longitudinal study for a follow-up COVID-19 study. During the parent study (2016-2018), participants completed a functional magnetic resonance imaging task eliciting neural activity to performance-related social feedback. Depressive symptoms were assessed during the parent study and COVID-19 follow-up (April-May 2020). In 65 participants with complete data, we examined how interactions between temperament and neural activation to social reward or punishment in a socio-affective brain network predict depressive symptoms during COVID-19.

RESULTS

Depressive symptoms increased during COVID-19. Significant interactions between temperament and caudate, putamen, and insula activation to social reward were found. Girls high in shy/fearful temperament showed negative associations between neural activation to social reward and COVID-19 depressive symptoms, whereas girls lower in shy/fearful temperament showed positive associations.

CONCLUSIONS

Girls high in shy/fearful temperament with reduced neural activation to social reward may be less likely to engage socially, which could be detrimental during the pandemic when social interactions are limited. In contrast, girls lower in shy/fearful temperament with heightened neural reactivity to social reward may be highly motivated to engage socially, which could also be detrimental with limited social opportunities. In both cases, improving social connection during the pandemic may attenuate or prevent depressive symptoms.

Hippocampal neurogenesis mediates sex-specific effects of social isolation and exercise on fear extinction in adolescence

Impaired extinction of conditioned fear is associated with anxiety disorders. Common lifestyle factors, like isolation stress and exercise, may alter the ability to extinguish fear. However, the effect of and interplay between these factors on adolescent fear extinction, and the relevant underlying neural mechanisms are unknown. Here we examined the effects of periadolescent social isolation and physical activity on adolescent fear extinction in rats and explored neurogenesis as a potential mechanism. Isolation stress impaired extinction recall in male adolescents, an effect prevented by exercise. Extinction recall in female adolescents was unaffected by isolation stress. However, exercise disrupted extinction recall in isolated females. Extinction recall in isolated females was positively correlated to the number of immature neurons in the ventral hippocampus, suggesting that exercise affected extinction recall via neurogenesis in females. Pharmacologically suppressing cellular proliferation in isolated adolescents using temozolomide blocked the effect of exercise on extinction recall in both sexes. Together, these findings highlight sex-specific outcomes of isolation stress and exercise on adolescent brain and behavior, and highlights neurogenesis as a potential mechanism underlying lifestyle effects on adolescent fear extinction.

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Periadolescent isolation stress disrupted extinction recall in male adolescents.

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Running prevented isolation-induced extinction recall deficit in male adolescents.

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Exercise impaired extinction recall in isolated female adolescents.

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Exercise increased hippocampal neurogenesis, except in isolated males.

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Suppression of neurogenesis blocked exercise effects in isolated adolescents.

Social Withdrawal and Romantic Relationships: A Longitudinal Study in Early Adulthood

Involvement in romantic relationships is a salient developmental task in late adolescence and early adulthood, and deviations from normative romantic development are linked to adverse outcomes. This study investigated to what extent social withdrawal contributed to deviations from normative romantic development, and vice versa, and the interplay between withdrawal and couples’ relationship perceptions. The sample included 1710 young adults (55–61% female) from the Tracking Adolescents’ Individual Lives Survey cohort and their romantic partners. Data were collected across 4 waves, covering romantic relationships from ages 17 to 29 years. The results showed that higher withdrawal predicted a higher likelihood of romantic non-involvement by adulthood, consistently being single at subsequent waves, and entering one’s first relationship when older. Withdrawal moderately decreased when youth entered their first relationship. Male’s withdrawal in particular affected romantic relationship qualities and dynamics. These results provide new insights into the developmental sequelae of withdrawn young adults’ romantic relationship development.

The longitudinal role of early family risks and early social-emotional problems for friendship quality in preadolescence-A regression model

The quality of a best friendship provides information about how developmentally beneficial it is. However, little is known about possible early risk factors that influence later friendship quality. The present study examined the role of family risks and social-emotional problems (behavioral problems, peer problems, anxious, and depressive symptoms) in early childhood for positive (i.e., support and help) and negative (i.e., conflicts and betrayal) dimensions of friendship quality with their best friend in preadolescence. 293 children (47.9% female) aged 2–4, their parents and teachers participated in the study with three measurement occasions (T1; M_age = 2.81, T2; M_age = 3.76, T3; M_age = 9.69). The last measurement occasion was at the age of 9–11 years. Results of the longitudinal regression model showed that depressive symptoms in early childhood were associated with a lower positive dimension of friendship quality in preadolescence. In contrast, early anxious symptoms were related to a higher positive dimension of friendship quality six years later. Neither family risks, nor behavioral problems and peer problems in early childhood were linked to the positive dimension of friendship quality in preadolescence. No early predictors were found for the negative dimension of friendship quality. Possible reasons for the lack of associations are discussed. Findings suggest that children with early depressive symptoms at 3–5 years of age should be the targets of potential interventions to form high quality friendships in preadolescence. Possible interventions are mentioned.

Die soziale Integration von Schülerinnen und Schülern mit sozialer Unsicherheit

Zusammenfassung. Der vorliegende Beitrag untersucht den Zusammenhang zwischen sozialer Integration und sozialer Unsicherheit. Ausgehend von dem mehrdimensionalen Modell sozialer Integration ( Koster, Nakken, Pijl & van Houten, 2009 ) wird diese differenziert anhand der Dimensionen Beziehungen, Kontakte, Akzeptanz durch Mitschülerinnen und Mitschüler und eigene Wahrnehmung analysiert. Hierfür wurden Daten von N = 617 Kindern aus insgesamt 28 Schulklassen der dritten und vierten Jahrgangsstufe geprüft. Die Ergebnisse der Mehrebenenanalysen zeigen einen signifikanten negativen Zusammenhang zwischen sozialer Unsicherheit und sozialer Integration in drei der vier Dimensionen (Beziehungen, eigene Wahrnehmung und Akzeptanz). Die Ergebnisse für die einzelnen Dimensionen werden diskutiert und es werden Implikationen für die Forschung und pädagogische Praxis abgeleitet.

From scanners to cell phones: neural and real-world responses to social evaluation in adolescent girls

While expanded use of neuroimaging seemed promising to elucidate typical and atypical elements of social sensitivity, in many ways progress in this space has stalled. This is in part due to a disconnection between neurobiological measurements and behavior outside of the laboratory. The present study uses a developmentally salient fMRI computer task and novel ecological momentary assessment protocol to examine whether early adolescent females (n = 76; ages 11–13) with greater neural reactivity to social rejection actually report greater emotional reactivity following negative interactions with peers in daily life. As hypothesized, associations were found between reactivity to perceived social threat in daily life and neural activity in threat-related brain regions, including the left amygdala and bilateral insula, to peer rejection relative to a control condition. Additionally, daily life reactivity to perceived social threat was associated with functional connectivity between the left amygdala and dorsomedial prefrontal cortex during rejection feedback. Unexpectedly, daily life social threat reactivity was also related to heightened amygdala and insula activation to peer acceptance relative to a control condition. These findings may inform key brain–behavior associations supporting sensitivity to social evaluation in adolescence.

The social withdrawal and social anxiety feedback loop and the role of peer victimization and acceptance in the pathways

Social withdrawal and social anxiety are believed to have a bidirectional influence on one another, but it is unknown if their relationship is bidirectional, especially within person, and if peer experiences influence this relationship. We investigated temporal sequencing and the strength of effects between social withdrawal and social anxiety, and the roles of peer victimization and acceptance in the pathways. Participants were 2,772 adolescents from the population-based and clinically referred cohorts of the Tracking Adolescents' Individual Lives Survey. Self- and parent-reported withdrawal, and self-reported social anxiety, peer victimization, and perceived peer acceptance were assessed at 11, 13, and 16 years. Random-intercept cross-lagged panel models were used to investigate within-person associations between these variables. There was no feedback loop between withdrawal and social anxiety. Social withdrawal did not predict social anxiety at any age. Social anxiety at 11 years predicted increased self-reported withdrawal at 13 years. Negative peer experiences predicted increased self- and parent-reported withdrawal at 13 years and increased parent-reported withdrawal at 16 years. In turn, self-reported withdrawal at 13 years predicted negative peer experiences at 16 years. In conclusion, adolescents became more withdrawn when they became more socially anxious or experienced greater peer problems, and increasing withdrawal predicted greater victimization and lower acceptance.

Parenting Interacts with Oxytocin Polymorphisms to Predict Adolescent Social Anxiety Symptom Development: A Novel Polygenic Approach

Guided by a developmental psychopathology framework, research has increasingly focused on the interplay of genetics and environment as a predictor of different forms of psychopathology, including social anxiety. In these efforts, the polygenic nature of complex phenotypes such as social anxiety is increasingly recognized, but studies applying polygenic approaches are still scarce. In this study, we applied Principal Covariates Regression as a novel approach to creating polygenic components for the oxytocin system, which has recently been put forward as particularly relevant to social anxiety. Participants were 978 adolescents (49.4% girls; M_age T₁ = 13.8 years). Across 3 years, questionnaires were used to assess adolescent social anxiety symptoms and multi-informant reports of parental psychological control and autonomy support. All adolescents were genotyped for 223 oxytocin single nucleotide polymorphisms (SNPs) in 14 genes. Using Principal Covariates Regression, these SNPs could be reduced to five polygenic components. Four components reflected the underlying linkage disequilibrium and ancestry structure, whereas the fifth component, which consisted of small contributions of many SNPs across multiple genes, was strongly positively associated with adolescent social anxiety symptoms, pointing to an index of genetic risk. Moreover, significant interactions were found with this polygenic component and the environmental variables of interest. Specifically, adolescents who scored high on this polygenic component and experienced less adequate parenting (i.e., high psychological control or low autonomy support) showed the highest levels of social anxiety. Implications of these findings are discussed in the context of individual-by-environment models.

Social anxiety and perceptions of likeability by peers in children

The current study aimed to investigate the discrepancy between self-reported and peer-reported likeability among children, and the relation with social anxiety, depression, and social support. In total, 532 children between 7 and 12 years completed questionnaires about social anxiety symptoms, depressive symptoms, and social support, estimated their own likeability, and indicated how much they liked their classmates. Children with higher levels of social anxiety or depression overestimated their likeability less or even underestimated their likeability. Social anxiety symptoms, but not depressive symptoms, were significant predictors of the discrepancy. Social support was positively related to likeability and negatively related to social anxiety, but did not moderate the association between social anxiety symptoms and perception accuracy of likeability. These results are in line with cognitive theories of childhood social anxiety, and they stress the importance of using multi-informant measures when studying the relation between social anxiety and social functioning in children.

Transactional Links Between Social Anxiety Symptoms and Parenting Across Adolescence: Between- and Within-Person Associations

This 4-year longitudinal multi-informant study examined between- and within-person associations between adolescent social anxiety symptoms and parenting (parental psychological control and autonomy support). A community sample of 819 adolescents (46.1% girls; Mage T1  = 13.4 years) reported annually on social anxiety symptoms and both adolescents and mothers reported on parenting. Between-person associations suggested that adolescent social anxiety symptoms were associated with higher adolescent- and mother-reported psychological control and lower mother-reported autonomy support. At the within-person level, however, mothers reported lower psychological control and higher autonomy support after periods with higher adolescent social anxiety symptoms. Our findings illustrate the importance of distinguishing among between-person and within-person associations and including perceptions of both dyad members in longitudinal research concerning parenting and adolescent mental health.

Mental health disorders and adolescent peer relationships

RATIONALE

Mental health disorders often arise during adolescence, with disruptive behavior disorders and anxiety disorders among the most common. Given the salience of peer relationships during adolescence, and research suggesting that mental health disorders negatively impact social functioning, this study uses novel methodology from social network analysis to uncover the social processes linking disruptive behavior disorders and anxiety disorders with adolescent friendships. In particular, the study focuses on peer withdrawal, peer popularity, and peer homophily in relation to both disorders.

METHODS

Data come from 15-year old students in four Scottish secondary schools (N = 602). Diagnoses of disruptive behavior disorders and anxiety disorders were produced using the Diagnostic Interview Schedule for Children, and peer relationship data were obtained through a friendship nomination survey. Exponential random graph models were used to estimate the probability of peer withdrawal, peer popularity, and peer homophily based on each disorder.

RESULTS

Results demonstrated that adolescents with disruptive behavior disorders were more popular than their peers without disruptive behavior disorders (OR: 1.47, CI: 1.20, 1.87). Friendship was also more likely between two adolescents both with or both without disruptive behavior disorders (OR: 1.26, CI: 1.07, 1.47), demonstrating peer homophily. There was no evidence that anxiety disorders were related to adolescent peer relationships.

CONCLUSIONS

Findings from this study suggest that disruptive behavior disorders may be socially rewarded (e.g., peer popularity) and socially clustered (e.g., homophily), whereas anxiety disorders show no such trends. Thus, intervention efforts must account for the peer social status that may be gained from engaging in disruptive behavior during this developmental period. Further, given that similarity in DBD status is associated with an increased likelihood of friendship, adolescents are likely to be surrounded by peers who reinforce their behaviors.

The experience of the self in Canadian youth living with anxiety: A qualitative study

BACKGROUND

Anxiety can create serious disruption in the life and mind of youth who are affected. Youth living with anxiety suffer a wealth of physical and psychological challenges, yet little is known about how anxiety influences the sense of the self. The purpose of this research was to explore the experience of the self in a sample of Canadian youth living with anxiety.

MATERIALS AND METHODS

The qualitative research approach of hermeneutic phenomenology was used. The sample consisted of 58 Canadian youth with anxiety, 44 females and 14 males between the ages of 10 and 22. Youth took part in open-ended interviewing, ecomaps, and photovoice. Data analysis followed a staged process, informed by Max van Manen. All sources of data were included in the analysis to form thematic statements.

RESULTS

Entering into the lifeworld of youth revealed that they suffered deeply. A fractured sense of self underlined their experience, setting up for a great deal of self-scrutiny and a lack of self-compassion. They experienced a profound sense of responsibility for others at the loss of being-there-for-oneself. Navigating their social sphere presented an additional challenge. However, youth were genuinely interested in self-discovery through awareness and reflection.

CONCLUSIONS

The phenomenological accounts by youth on living with anxiety reinforce the challenges they experienced within themselves that give rise to a great deal of inner turmoil. Care and support to youth with anxiety requires an understanding of the ways in which the self may be fractured by their experiences with anxiety. Providing young people with an opportunity to share with others who had similar lived experiences can serve to contribute to a sense of healing for youth, while also providing a safe space in which young people can let down their guard and openly acknowledge or share their experiences without fear of stigmatization.

Developmental Trajectories of Anxiety and Depression Symptoms from Early to Middle Childhood: a Population-Based Cohort Study in the Netherlands

Developmental patterns of anxiety and depression symptoms in early childhood have previously been related to anxiety and mood disorders in middle childhood. In the current study, trajectories of anxiety and depression symptoms (1.5-10 years) were related to children's broader psychosocial and school-related functioning at 10 years. We included a population-based sample of 7499 children, for whom primary caregivers reported anxiety and depression symptoms on the Child Behavior Checklist, at children's ages of 1.5, 3, 6, and 10. Growth Mixture Modeling identified four distinct, gender-invariant, trajectories of anxiety and depression symptoms: low (82.4%), increasing (7.4%), decreasing (6.0%), and increasing symptoms up to age 6 followed by a decrease to age 10 (preschool-limited, 4.2%). Children with a non-Dutch ethnicity had lower odds to be in the increasing trajectory and higher odds to be in the decreasing and pre-school limited trajectory. Also, low maternal education predicted the decreasing and pre-school limited trajectory. Higher levels of psychopathology during pregnancy for both mothers and fathers predicted the increasing, decreasing, and preschool-limited trajectory, compared to the low trajectory. At age 10, children in the increasing and preschool-limited trajectory had diminished psychosocial outcomes (friendship-quality and self-esteem) and worse school-related outcomes (school performance and school problems). This study adds to current knowledge by demonstrating that developmental patterns of anxiety and depression symptoms in early childhood are related to broader negative outcomes in middle childhood. Child and family factors could guide monitoring of anxiety and depression symptoms in the general population and provide targets for prevention programs.

Identifying Risk Profiles of School Refusal Behavior: Differences in Social Anxiety and Family Functioning Among Spanish Adolescents

School attendance problems negatively affect students' development. This study attempted to identify different school refusal behavior profiles and to examine their relationship with three dimensions of social anxiety (fear of negative evaluation, social avoidance and distress in new situations, and social avoidance and distress that is experienced more generally in the company of peers) and the perception of family functioning. Participants included 1842 Spanish adolescents (53% girls) aged 15-18 years (M = 16.43; SD = 1.05). The School Refusal Assessment Scale-Revised (SRAS-R), the Social Anxiety Scale for Adolescents (SAS-A), and the Family APGAR Scale (APGAR: Adaptation, Partnership, Growth, Affection, and Resolve) were administered. Latent class analysis revealed four school refusal behavior profiles: non-school refusal behavior, high school refusal behavior, moderately low school refusal behavior, and moderately high school refusal behavior. Analyses of variance (ANOVA) indicated that adolescents' with the profile of high school refusal behavior showed higher scores in all the subscales of social anxiety. In contrast, the non-school refusal behavior group revealed higher scores in the perception of good family functioning, whereas the high school refusal behavior profile obtained the lowest scores in this scale. These findings suggest that students who reject school are at a higher risk of developing social anxiety problems and manifesting family conflicts. These students should be prioritized in order to attend to their needs, promoting self-help to overcome social anxiety and family problems with the purpose of preventing school refusal behaviors.

What is the Role of Internalizing and Externalizing Symptoms in Adolescent Suicide Behaviors?

Suicide is the second leading cause of death in adolescents and young adults aged 15 to 29 years. Specifically, the presence of internalizing and externalizing symptomatology is related to increased risk for suicide at these ages. Few studies have analyzed the relations between these symptoms and their role as mediators in predicting suicide behavior. This study aimed to examine the relation between internalizing and externalizing symptomatology and suicide behaviors through a longitudinal study. The sample consisted of 238 adolescents aged 12 to 18 years. The data were analyzed via the PROCESS Statistical Package. The main results showed that previous depression symptoms had a significant indirect effect, through previous suicide behaviors and current depression symptoms, on current suicide behaviors, accounting for 61% of the total variance explained. Additionally, being a girl increased this risk. Therefore, the implementation of early identification and intervention programs to address youth symptoms of depression and suicidal behaviors could significantly reduce the risk for future suicidal behaviors in adolescence.

Associations Between Anxious and Depressive Symptoms and the Recognition of Vocal Socioemotional Expressions in Youth

The current study examined the associations between internalizing symptoms and adolescents' recognition of vocal socioemotional expressions produced by youth. Fifty-seven youth (8-17 years old, M = 12.62, SD = 2.66; 29 anxious, 28 nonanxious; 32 female, 25 male) were asked to identify the intended expression in auditory recordings of youth's portrayals of basic emotions and social attitudes. Recognition accuracy increased with age, suggesting that the ability to recognize vocal affect continues to develop into adolescence. Anxiety symptoms were not associated with recognition ability, but youth's depressive symptoms were related to poorer identification of anger and happiness. Youth experiencing symptoms of depression may be likely to misinterpret vocal expressions of happiness and anger.

Social Withdrawal in Adolescence and Early Adulthood: Measurement Issues, Normative Development, and Distinct Trajectories

Social withdrawal during adolescence and early adulthood is particularly problematic due to the increasing importance of social interactions during these ages. Yet little is known about the changes, trajectories, or correlates of being withdrawn during this transition to adulthood. The purpose of this study was to examine the normative change and distinct trajectories of withdrawal in order to identify adolescents and early adults at greatest risk for maladjustment. Participants were from a Dutch population-based cohort study (Tracking Adolescents' Individual Lives Survey), including 1917 adolescents who were assessed at four waves from the age of 16 to 25 years. Five items from the Youth Self Report and Adult Self Report were found to be measurement invariant and used to assess longitudinal changes in social withdrawal. Overall, participants followed a U-shaped trajectory of social withdrawal, where withdrawal decreased from ages 16 to 19 years, remained stable from 19 to 22 years, and increased from 22 to 25 years. Furthermore, three distinct trajectory classes of withdrawal emerged: a low-stable group (71.8%), a high-decreasing group (12.0%), and a low-curvilinear group (16.2%). The three classes differed on: shyness, social affiliation, reduced social contact, anxiety, and antisocial behaviors. The high-decreasing group endorsed the highest social maladjustment, followed by the low-curvilinear group, and the low-stable group was highly adjusted. We discuss the potential contribution of the changing social network in influencing withdrawal levels, the distinct characteristics of each trajectory group, and future directions in the study of social withdrawal in adolescence and early adulthood.

Reciprocal Longitudinal Associations Between Adolescents' Media Consumption and Psychological Health

OBJECTIVE

This study investigated reciprocal longitudinal associations between media use/physical activity and adolescents' psychological health.

METHODS

Data were collected between 2011 and 2017 in the LIFE Child study in Germany. The sample included 814 10- to 17-year-old adolescents. The participants provided information on their media use per day (hours of television/video, computer/Internet, and mobile phone use), physical activity (frequency of organized and non-organized physical activity per week), behavioral difficulties (emotional problems, conduct problems, hyperactivity/inattention, peer relationship problems), and quality of life (physical and psychological well-being; satisfaction with parents, peers, and school) at 2 time points 12 months apart. Multiple regressions were applied to analyze reciprocal longitudinal associations between media use/physical activity and behavioral difficulties/quality of life.

RESULTS

Frequent use of computers/Internet at baseline was associated with an increase in internalizing behavioral difficulties (emotional problems and peer relationship problems) at follow-up. Additionally, a high frequency of computer/Internet and mobile phone use was related to a decrease in psychological well-being, whereas a high frequency of organized physical activity was linked to improved physical well-being. The analyses also revealed a link between more behavioral difficulties at baseline and increased television consumption at follow-up.

CONCLUSION

This study suggests mutual dependencies between electronic media use and psychological health over time.