Childhood Adversity, Timing of Puberty and Adolescent Depressive Symptoms: A Longitudinal Study in Taiwan

Long-term effects of health during childhood on depressive symptoms in later life: evidence from a nationally representative survey in China

BACKGROUND

Childhood health significantly influences mental well-being in later life, but this relationship remains underexplored in China. This study aims to investigate the long-term associations between childhood health status and depressive symptoms in older adults, emphasizing the need for early interventions to promote lifelong mental health.

METHODS

We utilized data from a nationally representative survey conducted across 28 provinces of China, comprising 15,581 adults aged 45 years and older. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression scale. Logistic regression and decision tree models were applied to examine the association between childhood health and depressive symptoms in later life.

RESULTS

The overall prevalence of depressive symptoms among participants was 33.75%. Those reporting excellent or very good childhood health had a lower prevalence (29.99%), while those with poor childhood health reported a markedly higher rate (47.57%). After adjusting for demographics and lifestyle factors, poor childhood health was associated with a higher likelihood of depressive symptoms (AOR 1.83, 95% CI 1.56-2.14, P < 0.0001). Other risk factors included aged 65-74 years (AOR 1.23, 95% CI 1.10-1.38, P = 0.0009), female gender (AOR 2.01, 95% CI 1.78-2.28, P < 0.0001), and never drinking (AOR 1.24, 95% CI 1.11-1.38, P = 0.0012). Protective factors included tertiary education (AOR 0.45, 95% CI 0.32-0.65, P = 0.0030), higher BMI (BMI 24-27.9 kg/m2: AOR 0.72, 95% CI 0.60-0.87 kg/m2, P = 0.0033; BMI ≥ 28 kg/m2: AOR 0.69, 95% CI 0.56-0.85 kg/m2, P = 0.0030), sleep duration of seven or more hours (7-10 h sleep: AOR 0.52, 95% CI 0.48-0.57, P < 0.0001; ≥10 h sleep: AOR 0.50, 95% CI 0.43-0.58, P < 0.0001), never smoked (AOR 0.77, 95% CI 0.68-0.86, P < 0.0001), and urban residency (AOR 0.57, 95% CI 0.50-0.64, P < 0.0001). The decision tree model highlighted key factors associated with depressive symptoms, including childhood health, non-communicable diseases, sleep duration, residency, alcohol consumption, and smoking status.

CONCLUSIONS

Our findings suggest that childhood health may influence mental well-being in later life. Promoting healthy behaviors from early childhood could help reduce depression risk in older age. However, the reliance on self-reported data and a cross-sectional design limit causal interpretation. Preventive care and targeted interventions for vulnerable children should be prioritized to improve long-term mental health outcomes.

Developmental Trajectory of Depressive Symptoms among Left-behind Children in Rural China: The Roles of Family Adversity and Personal Growth Initiative

The adversity faced by left-behind children due to parental migration affects their depressive symptoms, but little is known about the mechanism underlying this association and protective factors from a dynamic perspective. The present study examined the association between family adversity and the developmental trajectory of depressive symptoms, and the potential mediating and moderating role of personal growth initiative in this association among left-behind children. A total of 363 left-behind children (48.8% female; Mage = 12.97 at T1, SDage = 0.55) from five rural middle schools in the Hunan Province of China participated in this three-wave study, employing one-year intervals between assessments. The results indicated the initial level of personal growth initiative mediated the association between family adversity at T1 and the development of depressive symptoms, while the growth rate of personal growth initiative both mediated and moderated this association, with consistent effects across sexes. These findings underscore the critical role of personal growth initiative in the association between family adversity and depressive symptoms among left-behind children.

Exercise as a mediator between childhood adversity and psychological distress: Can BDNF moderate the mediating effect?

BACKGROUND

Adverse childhood events (ACEs) have been associated with an increased risk of psychiatric disorders in young adulthood. To identify at-risk individuals and potential strategies to combat the negative impacts of ACE, this study investigated the mediating role of exercise in the relationship between psychological distress and ACEs. Further, we examined the moderating effect of the BDNF polymorphism in the mediation relationship.

METHODS

Participants (N = 750, Mage = 20.1 years) completed questionnaires assessing ACEs divided into adverse environment (AE) and childhood maltreatment (CM), exercise, and psychological distress. Salivary genomic DNA was used for genotyping. The significance of the moderated mediation model was assessed using bootstrapping.

RESULTS

There was a significant association between ACEs and psychological distress mediated by exercise. After addition of BDNF polymorphism, we found that the effect of ACEs on psychological distress through exercise was moderated by the BDNF polymorphism (index of moderated mediation = -0.19, [-0.48, -0.04], p-value ≤0.05). Further dividing ACE into AE and CM, the moderated mediation relationship remains significant only with AE (index of moderated mediation = -0.41, [-0.99, -0.10], p-value ≤0.05).

CONCLUSIONS

The interaction between BDNF polymorphism and exercise may be a suitable target for interventions in ACEs-experienced individuals for the prevention or reduction of psychological distress.

Earlier pubertal timing, not tempo, links time-limited early adversity with psychopathology

Evolutionary-developmental theories propose that early adverse experiences adaptively shift the timing (i.e., onset) and tempo (i.e., rate) of pubertal maturation. Empirical evidence of links between early life adversity and pubertal maturation is mixed, potentially in part because isolating the unique impacts of early environments is challenging. The current accelerated longitudinal study used a quasi-experimental design to examine pubertal maturation among 132 previously-institutionalized (PI), internationally adopted children who experienced a time-limited form of severe early life adversity, compared to 169 non-adopted (NA) children. Based on prior literature, we also assessed whether pubertal timing and/or tempo are pathways by which early adversity relates to later symptoms of psychopathology. At each of three annual sessions, Tanner pubertal staging was determined by nurse exam, and symptoms of psychopathology were captured in a composite of child self-reported internalizing and parent-reported externalizing symptoms. Findings revealed that, only among children at Tanner pubertal stages 3 or below, PI children were more likely to have reached stage 3 compared to NA children, reflective of earlier pubertal timing. No group differences were found for pubertal tempo. In the subsample of children at Tanner stage 3 or lower, earlier pubertal timing was an indirect pathway by which early adversity related to both higher levels and greater longitudinal declines in internalizing and externalizing symptoms of psychopathology, accounting for a small proportion of the total effect of early adversity on psychopathology. Results from this quasi-experimental study add to existing research on associations between early adversity, early pubertal timing, and psychopathology, further suggesting that links may be specific to timing but not tempo. While findings broadly align with recent calls to consider early pubertal maturation as a transdiagnostic risk marker with utility for identifying children who could benefit from early mental health intervention, they also suggest that pubertal timing is unlikely to be a robust target for reducing psychopathology risk in these children.

Coming of age in war: Early life adversity, age at menarche, and mental health

Armed conflict and forced migration (ACFM) represent a set of extreme environments that are increasingly common for children and adolescents to experience. Adolescence may constitute a sensitive period (puberty and psychoneurological maturation) through which ACFM adversity leaves a lasting mark. Adolescence has become a focal point for analysis and intervention as it relates to the effects of early life adversity on puberty, linear growth, and mental health. Research in public health and psychological science suggests early life adversity (ELA) may accelerate puberty, heightening risks for mental health disorders. However, it is not well substantiated whether ACFM-derived adversities accelerate or delay relative pubertal timing. Secondly, ACFM provides salient context through which to probe the relationships between nutritional, psychosocial, and demographic changes and their respective impact on puberty and mental health. We conducted a narrative review which 1) examined constructions of early life adversity and their proposed influence on puberty 2) reviewed empirical findings (n = 29 studies, n = 36 samples) concerning effects of ACFM ELA on age at menarche and 3) discussed proposed relationships between early life adversity, puberty, and mental ill-health. Contrary to prior research, we found war-derived early life adversity was more consistently associated with pubertal delay than acceleration and may exert counterintuitive effects on mental health. We show that ELA cannot be operationalized in the same way across contexts and populations, especially in the presence of extreme forms of human stress and resilience. We further discuss the ethics of puberty research among conflict-affected youth.

Experience-dependent neurodevelopment of self-regulation in adolescence

Adolescence is a period of rapid biobehavioral change, characterized in part by increased neural maturation and sensitivity to one's environment. In this review, we aim to demonstrate that self-regulation skills are tuned by adolescents' social, cultural, and socioeconomic contexts. We discuss adjacent literatures that demonstrate the importance of experience-dependent learning for adolescent development: environmental contextual influences and training paradigms that aim to improve regulation skills. We first highlight changes in prominent limbic and cortical regions-like the amygdala and medial prefrontal cortex-as well as structural and functional connectivity between these areas that are associated with adolescents' regulation skills. Next, we consider how puberty, the hallmark developmental milestone in adolescence, helps instantiate these biobehavioral adaptations. We then survey the existing literature demonstrating the ways in which cultural, socioeconomic, and interpersonal contexts drive behavioral and neural adaptation for self-regulation. Finally, we highlight promising results from regulation training paradigms that suggest training may be especially efficacious for adolescent samples. In our conclusion, we highlight some exciting frontiers in human self-regulation research as well as recommendations for improving the methodological implementation of developmental neuroimaging studies and training paradigms.

The different role of adversity before and after birth in adolescent depression

BACKGROUND

Early adversity is strongly linked to adolescent depression, but there is limited research on the impact of indirect exposure to adversity before birth and the distinct role of adversity before and after birth.

METHODS

A total of 1911 Chinese adolescents (48.8 % males; ages 11 to 19, Mean = 13.96) reported early adversities before and after birth, depression, negative self-cognition and perceived school climate. Structural equation model was used to test the association between early adversity before/after birth and adolescent depression, with negative self-cognition serving as a mediator and school climate as a moderator.

RESULTS

Adversity before birth was related to adolescent depression through the full mediating role of negative self-cognition. Furthermore, it was more associated with negative self-cognition in schools with a more favorable climate. Adversity after birth was related to adolescent depression through the partial mediating role of negative self-cognition, and school climate played a nonsignificant moderating role in the mediating path.

LIMITATIONS

Early adversity was measured through adolescent reports, possibly generating recall bias. The cross-sectional design should be taken into consideration when drawing conclusions about causality.

CONCLUSIONS

Adversities before and after birth are associated with adolescent depression in distinct ways. The more association between adversity before birth and negative self-cognition in a favorable school climate supports the "healthy context paradox." Interventions that target depression should focus on promoting a positive school climate and helping adolescents who have experienced early adversity bolster positive self-cognition.

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

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

Pubertal progression and its relationship to psychological and behavioral outcomes among adolescent boys

Variations in pubertal timing and tempo have relevance to psychosocial development. Accounting for pubertal timing, tempo, and psychosocial development simultaneously in a model remains challenging. This study aimed to document the typology of pubertal development in a cohort of Taiwanese adolescent boys and then to examine how the associations between psychosocial variables across time vary by the patterns of pubertal development. A group of adolescent boys (n = 1,368) reported pubertal signs and psychosocial variables for 3 years since seventh grade. The growth mixture model revealed three major classes of pubertal transition: average pubertal growth, late-onset with rapid catch-up, and late-onset with slow catch-up. In a cross-lagged panel model, the multigroup analysis found the regression coefficients mostly invariant across all three classes, except those between deviant behavior and subsequent changes in depressive symptoms that were significantly positive only in the late-onset with slow catch-up group. Adolescent boys in this group were estimated to have the highest marginal level of depressive symptoms and deviant behavior in ninth grade among the three classes. Our study highlights the heterogeneity in boys' pubertal development and the role of the pubertal development pattern in their psychosocial development.

The dynamics of adolescents’ pubertal maturation, depressive symptoms and friendship networks: stochastic actor-oriented model

This study aimed to examine whether adolescents select friends based on their friends’ levels of depressive symptoms, and to determine whether the potential homophily phenomenon for depressive symptoms is attenuated after considering pubertal maturation and gender. Data were from the first three waves of the Taiwan Youth Project, a longitudinal study that annually surveys 7th graders from 40 junior high schools. Participants were asked at each wave to fill out a survey including depressive symptoms, pubertal maturation, and to name three best friends in school. Stochastic actor-oriented models were built to explore the dynamic changes in friendship networks by estimating the probability of the friendship connections and behavioral changes depending on the individual’s current network position and behavioral status. We used a sample of 2,336 adolescents. From 8 to 9th grade, adolescents tended to select friends who were similar in terms of their levels of depressive symptoms (B = 0.358, SE = 0.131, p < .001), without adjusting for gender and pubertal maturation. This homophily effect based on depressive symptoms became non-significant when pubertal maturation was included. Adolescents’ depressive symptoms did not further influence their friends’ depression levels, after controlling for pubertal maturation and gender. Future studies should further examine the mechanisms and group dynamics within clusters of adolescents who are depressed. Providing a supportive environment and tools is warranted to help adolescents cope with negative emotions within their peer group.

Time Dimension of Childhood Adversities and Externalizing Behavior Among Children of Teen Mothers: Sensitive Period Hypothesis vs. Accumulation Hypothesis

Childhood adversities are associated with compromised behavioral health later in life. However, less attention has been paid to how time contributes to the damaging effects of adversity exposure. In addition, the differential impact of childhood maltreatment and household dysfunction has been understudied. The current study tested (a) the sensitive period hypothesis regarding timing of childhood adversity on externalizing behavior, (b) the accumulation hypothesis regarding the associations between the duration of childhood adversity and externalizing behavior, and (c) the domain-specific impact of childhood adversity on externalizing behavior. Data came from the Young Women and Child Development Study (N = 240). Childhood adversity was measured at seven periods (age range: 5.5-16), which were used to test the sensitive period hypothesis. Childhood adversity at each time period was summed across seven time periods to test the accumulation measure representing the duration of childhood adversity. Least angle and multiple regression analyses were conducted. Results supported the sensitive period hypothesis-the effect of childhood adversity was the most prominent at age 11.5, whereas the accumulation of childhood adversity time periods was not a significant predictor of later externalizing behavior. Probing childhood adversity by subdomains revealed maltreatment primarily accounted for externalizing behavior (p < .05). Findings suggest intervention efforts for children of teen mothers during early adolescence to prevent externalizing behavior in later adolescence. Unpacking childhood adversity may illuminate key areas of vulnerability to externalizing behavior.

Visualization analysis of junior school students' pubertal timing and social adaptability using data mining approaches

Pubertal timing and social adaptability are important research contents of adolescent mental health education. Traditional research methods mainly classify students based on the total score or average score of the scale, although this kind of method is simple easy to conduct, it can't make a more detailed analysis of the students. In this paper, data mining methods such as association rules and clustering are used to analyze the data of pubertal timing and social adaptability scale, some novel and meaningful conclusions are figured out from the analysis results that can't be obtained by the previous methods, and the analysis results are visualized to enhance readability. Association rule mining on basic attributes information, the pubertal timing group and the social adaptability levels were performed which can explore the relationship between the basic attributes information of the students, pubertal timing and the social adaptability. Fine-grained analysis of social adaptability by using clustering method was conducted which can divide the similar students into the same groups that is very useful for teachers to have a more in-depth, accurate and detailed understanding of students, make sure that the better classification can be obtained compared with the traditional analysis approaches. The work of this paper provides an effective guidance and a novel perspective for how to use data mining technologies to study the pubertal timing and social adaptability problems.

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Data mining is a new way to study pubertal timing and social adaptability problems.

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Clustering method can divide the similar students in many aspects into the same group.

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The radar chart shows that the role of each subscale is different.

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Data mining methods can help teachers to have detailed understanding of students.

The effect of high school entrance exam reform on adolescents’ depressive symptoms in Taiwan: A closer look at gender differences

In the current study, we followed motivational theories and investigated whether granting junior high school students one more opportunity to take the high-stakes high school entrance exam alleviates students’ depressive symptoms, and whether the effect is comparable for adolescent boys and girls residing in Taiwan. We analyzed two longitudinal datasets (seventh to tenth grade) from two neighboring cohorts, in which one cohort could take the exam just once (i.e., the pre-reform cohort) and the other twice (i.e., the post-reform cohort). Using a lagged-dependent-variable difference-in-differences model to compare the level of depressive symptoms before and after the entrance exam for the two cohorts, the results revealed that the reform was associated with increases in the level of depressive symptoms for both boys and girls. Despite a higher level of depressive symptoms overall, adolescent girls in the post-reform cohort showed a slower increase in the level of depressive symptoms than boys.

Effect of aromatherapy on autonomic nervous system regulation with treadmill exercise-induced stress among adolescents

Introduction

Stress is a major health issue in adolescents owing to the important transitions experienced during this period. Aromatherapy is an effective method for the reduction of stress in adolescents.

Purpose

The aims of this study were to examine the effect of aromatherapy on the regulation of the autonomic nervous system (ANS) along with stress relief and to explore the effect of aromatherapy on adolescents with different levels of stress.

Methods

This quasi-experimental study comprised three types of treatments: control (no essential oil), pure essential oil therapy (sandalwood), and blended essential oil therapy (sandalwood-lavender). The heart rate variability (HRV) was calculated to evaluate the post-exercise recovery of the ANS to the baseline level in the recruited adolescents. To examine the efficiency of aromatherapy, Friedman test was used to assess the significance of difference in all parameters (i.e., mean heart rate, SDNN, normalized LF, normalized HF, and LF/HF) between baseline and after exercise among the three treatment conditions.

Results

The participants comprised 43 junior college students (8 males and 35 females) with a mean age of 18.21 ± 0.99. Significant differences in changes of two HRV parameters (normalized LF and LF/HF) were associated with both essential oil therapies compared to those in the control group (p<0.05), and one more HRV parameter (normalized HF) exhibited significant difference related to blended essential oil therapy compared to that of the control group. Besides, changes in two HRV parameters (mean heart rate and normalized HF) of both essential oil therapies in the low level stress subgroup showed significant differences compared to those of the control group (p<0.05).

Conclusions

This study demonstrated that aromatherapy could be used for ANS regulation with stress-relieving effects in adolescents. The participants with a low stress level appeared to respond better to the blended essential oil therapy, whereas those with medium to high levels of stress appeared to respond poorly to aromatherapy compared to the control.

Childhood adversity, pubertal timing and self-harm: a longitudinal cohort study

BACKGROUND

The occurrence of early childhood adversity is strongly linked to later self-harm, but there is poor understanding of how this distal risk factor might influence later behaviours. One possible mechanism is through an earlier onset of puberty in children exposed to adversity, since early puberty is associated with an increased risk of adolescent self-harm. We investigated whether early pubertal timing mediates the association between childhood adversity and later self-harm.

METHODS

Participants were 6698 young people from a UK population-based birth cohort (ALSPAC). We measured exposure to nine types of adversity from 0 to 9 years old, and self-harm when participants were aged 16 and 21 years. Pubertal timing measures were age at peak height velocity (aPHV - males and females) and age at menarche (AAM). We used generalised structural equation modelling for analyses.

RESULTS

For every additional type of adversity; participants had an average 12-14% increased risk of self-harm by 16. Relative risk (RR) estimates were stronger for direct effects when outcomes were self-harm with suicidal intent. There was no evidence that earlier pubertal timing mediated the association between adversity and self-harm [indirect effect RR 1.00, 95% confidence interval (CI) 1.00-1.00 for aPHV and RR 1.00, 95% CI 1.00-1.01 for AAM].

CONCLUSIONS

A cumulative measure of exposure to multiple types of adversity does not confer an increased risk of self-harm via early pubertal timing, however both childhood adversity and early puberty are risk factors for later self-harm. Research identifying mechanisms underlying the link between childhood adversity and later self-harm is needed to inform interventions.

Effects of childhood adversity trajectories on mental health outcomes in late adolescence: The buffering role of parenting practices in Taiwan

BACKGROUND

Childhood adversities (CAs) have been linked with unfavorable development; however, the chronic trajectories of multiple CAs and possible heterogeneous effects are understudied.

OBJECTIVES

This study examined the trajectories of multiple CAs and their associations with mental health outcomes in adolescence and investigated the buffering effect of parenting practices.

PARTICIPANTS AND SETTING

We used population-representative data from the Taiwan Education Panel Survey (2005 and 2007, n = 10,416).

METHODS

This study was based on retrospectively self-reporting of six CAs, namely physical abuse, family economic hardship, parental problematic drinking, parental catastrophic health problems, parental divorce, and parental death, at three developmental periods: early childhood, middle childhood, and early adolescence. Group-based multitrajectory modeling and multiple regressions were used to identify distinct trajectories of multiple CAs and evaluate the association estimates.

RESULTS

A total of four trajectory groups were identified: increasing family economic hardship (12.3 %), chronic physical abuse (3.3 %), chronic parental problematic drinking (2.8 %), and low adversity (81.6 %). The chronic physical abuse group had the highest levels of depressive symptoms (β = 6.61, p < .001) and suicidal ideation (Adjusted Odds Ratio [AOR] = 2.67, p < .001), whereas the chronic parental problematic drinking group had the highest level of substance abuse (AOR = 4.59, p < .001). Positive parental practices buffered the harmful effects of increasing family economic hardship in late adolescence, particularly for depressive symptoms and substance abuse.

CONCLUSIONS

Adverse mental health outcomes varied among groups with distinct multiple CA trajectories. The provision of social services to train or support positive parenting practices in families experiencing economic hardship is a potentially valuable resilience strategy.

Stressful life events and adolescent well-being: The role of parent and peer relationships

It is well established that stressful life events (e.g., family bereavements or moving to a new country) are damaging to psychological health and well-being. Indeed, social relationships are often noted as an important factor that can influence well-being and buffer the negative effects of stress. However, the quality and source of these relationships, particularly for adolescents, are often overlooked. Using the Growing Up in Ireland Survey, a population-based study of 13-year-old Irish adolescents (N = 7,525; 51.1% female), the current study examines the quality of both parent and peer relationships as potential mechanisms explaining the association between stressful life events and psychological well-being indices in adolescents. As expected, results showed that stressful life events negatively impacted the psychological well-being of adolescents. Parallel mediation analyses indicated that both parent and peer relationship quality mediated this association. Further exploratory analyses found that for girls, greater numbers of stressful life events were associated with poorer quality relationships with both their parents and peers, and in turn, these were linked to lower levels of psychological well-being. For boys, this effect was only evident for parental relationship quality, but not peers. The implication of these findings for adolescent's psychological well-being, particularly for girls, is discussed.

Factor Structure of the 10-Item Perceived Stress Scale and Measurement Invariance Across Genders Among Chinese Adolescents

BACKGROUND

Chinese adolescents encounter a lot of stressors, such as academic burden and parental pressure. However, little is known about their perception of stress. The 10-item Perceived Stress Scale (PSS-10) is a widely used instrument to measure individuals' appraisal of global stress in academic research and clinical practice. The current study aimed to evaluate the best-fit factor structure model of the PSS-10 and the measurement invariance across genders in Chinese adolescents.

METHODS

A total of 1,574 Chinese senior high school students completed the PSS-10 (mean age = 15.26 ± 0.56 years, female = 54%). Confirmatory factor analysis (CFA) was conducted to determine the factor structure of the PSS-10. Multigroup CFA was carried out to test the measurement invariance of the PSS-10 across genders. A subsample (N = 1,060) answered additional questionnaires measuring stressful life events, anxiety, and depression to examine the convergent and concurrent validity of the PSS-10.

RESULTS

The two-factor model was supported [i.e., χ2 (34) = 332.224, p < 0.001; non-normal fit index (NNFI) = 0.901, comparative fit index (CFI) = 0.925, root mean square error of approximation (RMSEA) = 0.075, standardized root mean square residual (SRMR) = 0.051]. Importantly, the model exhibited strong measurement invariance across female and male groups. Furthermore, the PSS-10 had adequate convergent validity for stressful life events (number: r = 0.13, p < 0.001; impact: r = 0.23, p < 0.001) and could explain incremental variance in predicting anxiety (ΔR 2 = 0.13, β = 0.38, p < 0.001) and depression (ΔR 2 = 0.16, β = 0.41, p < 0.001), suggesting excellent concurrent validity.

CONCLUSION

A two-factor model best fits the structure of PSS-10 among Chinese adolescents, with strong measurement invariance between gender groups, demonstrating its validity for assessing perceived stress among Chinese adolescents.

Effects of childhood adversity and resilience on Taiwanese youth health behaviors

BACKGROUND

Adverse childhood experiences (ACEs) can leave negative impacts on one's health behaviors or social functioning later in life. Resilient characteristics have been shown to mitigate effects against risk behaviors in developing adolescents. However, clinical and research attention has rarely been given to jointly consider the effects of ACEs and resilient characteristics on health behaviors in Taiwanese youth.

METHOD

A total of 200 individuals aged 15-22 years were recruited from primary care settings, communities, and schools. Participants completed questionnaires assessing their ACEs, resilient characteristics, and health behaviors. Univariate analysis was firstly used to describe the correlates of ACEs and resilient characteristics. Further multivariate logistic regression analysis was used to examine the association of both factors with health behaviors.

RESULTS

More than half (61.5%) of those surveyed had been exposed to at least one category of ACE. Verbal (37%) and physical (21%) abuses were the most common types of ACEs. The counts in the ACE categories were associated with being involved in physical fights (odds ratio 1.28 [confidence interval 1.01-1.63]), property damage (1.29 [1.03-1.61]), running away from home (1.30 [1.05-1.60]), bullying victimization (1.37 [1.16-1.61]), and sleep problems/tiredness (1.25 [1.03-1.52]). Meanwhile, resilience scores were associated with decreased odds of infrequent seatbelt use (0.47 [0.23-0.97]), low fruit and vegetable intake (0.42 [0.21-0.86]) unsatisfied body image (0.46 [0.22-0.97]), and sleep problems/tiredness (0.37 [0.18-0.79]).

CONCLUSIONS

ACEs and resilience characteristics play a significant role in shaping youth health behaviors. Further research should be undertaken to identify ways to build resilience against health risks in youth with prior ACE exposure.

The possible mediating effect of alcohol dependence on the relationship between adverse childhood experiences and attempted suicide

Adverse childhood experiences (ACEs) and alcohol dependence (AD) carry independent risks for suicidal behavior. While the strength of the association between ACEs and attempted suicide is weakened following adjustment for AD, no study to date has directly been performed to determine whether AD affects the risk of suicide attributable to ACEs. The study aimed to examine the possible role of alcohol dependence (AD) in the relationship between various ACEs and attempted suicide. This cross-sectional study assessed history of ACEs among 184 AD patients and 205 control participants using the Family Health Questionnaire. Lifetime history of attempted suicide was collected using the Chinese version of the Composite International Diagnostic Interview. We used the Sobel test to examine the mediating effects of AD on the relationship between ACEs and attempted suicide. Results showed that the suicide attempters were associated with higher rates of AD and ACEs. The regression analysis showed that AD and multiple ACEs exposure are independently associated with attempted suicide. AD appears as a partial mediator in the relationship between attempted suicide and the specific type of ACE (exposure to a battered mother or sexual abuse) or exposure to ≥3 types of ACEs. We conclude that AD might partially mediate the associations detected between attempted suicide and exposure to a battered mother, sexual abuse, and ≥3 types of ACEs. These observations may provide important insight for intervention strategies aimed at reducing the risk of suicide attempts.

Psychometric evaluation of the Persian Internet Disorder Scale among adolescents

BACKGROUND AND AIMS

Given the growing epidemiological research interest concerning Internet addiction, brief instruments with a robust theoretical basis are warranted. The Internet Disorder Scale (IDS-15) is one such instrument that can be used to quickly assess the Internet addiction in an individual. However, only two language versions of the IDS-15 have been developed. This study translated the IDS-15 into Persian and examined its psychometric properties using comprehensive psychometric testing.

METHODS

After ensuring the linguistic validity of the Persian IDS-15, 1,272 adolescents (mean age = 15.53 years; 728 males) completed the IDS-15, Depression Anxiety Stress Scale (DASS), Internet Gaming Disorder Scale - Short Form (IGDS9-SF), and the Bergen Social Media Addiction Scale (BSMAS). Confirmatory factor analysis (CFA), Rasch models, regression analysis, and latent profile analysis (LPA) were carried out to test the psychometric properties of the Persian IDS-15.

RESULTS

Both CFA and Rasch supported the construct validity of the Persian IDS-15. Multigroup analysis in CFA and differential item functioning in Rasch indicated that male and female adolescents interpreted the IDS-15 items similarly. Regression analysis showed that the IDS-15 correlated with IGDS9-SF and BSMAS (ΔR² = .12 and .36, respectively) is stronger than the DASS (ΔR² = .03-.05). LPA based on IDS-15 suggests three subgroups for the sample. Significant differences in depression, anxiety, IGDS9-SF, and BSMAS were found among the three LPA subgroups.

CONCLUSION

The Persian IDS-15 has robust psychometric properties as evidenced by both classical test theory and Rasch analysis.

Adolescent Internet Use, Social Integration, and Depressive Symptoms: Analysis from a Longitudinal Cohort Survey

OBJECTIVE

To examine the association between adolescent leisure-time Internet use and social integration in the school context and how this association affects later depressive symptoms among adolescents in Taiwan, using a large nationwide cohort study and the latent growth model (LGM) method.

METHODS

Data of 3795 students followed from the year 2001 to 2006 in the Taiwan Education Panel Survey were analyzed. Leisure-time Internet use was defined by the hours per week spent on (1) online chatting and (2) online games. School social integration and depressive symptoms were self-reported. We first used an unconditional LGM to estimate the baseline (intercept) and growth (slope) of Internet use. Next, another LGM conditioned with school social integration and depression was conducted.

RESULTS

Approximately 10% of the participants reported engaging in online chatting and/or gaming for more than 20 hours per week. Internet use for online chatting showed an increase over time. School social integration was associated with the baseline amount (coefficient = -0.62, p < 0.001) but not the growth of leisure-time Internet use. The trend of Internet use was positively related to depressive symptoms (coefficient = 0.31, p < 0.05) at Wave 4.

CONCLUSION

School social integration was initially associated with decreased leisure-time Internet use among adolescents. The growth of Internet use with time was not explainable by school social integration but had adverse impacts on depression. Reinforcing adolescents' bonding to school may prevent initial leisure-time Internet use. When advising on adolescent Internet use, health care providers should consider their patients' social networks and mental well-being.

Transitions of Developmental Trajectories of Depressive Symptoms Between Junior and Senior High School Among Youths in Taiwan: Linkages to Symptoms in Young Adulthood

We investigated the heterogeneous developmental trajectories of depressive symptoms in junior and senior high school, the transitions to different trajectories after entering senior high school, and the linkages to the development of depressive symptoms in early adulthood among Taiwanese adolescents. An eight-wave longitudinal data set was analyzed, including 2687 Taiwanese adolescents (51.2% boys, M age = 14.3 at first wave). Using a manual three-step latent transition growth mixture model, we found that a three-class solution fit the data for both junior high school (termed high-improving, cumulative, and JS-low-stable) and senior high school period (termed heightening, moderate-stable, and HS-low-stable). The depressive symptoms of most individuals maintained at a low level (i.e., low-stable) from adolescence to early adulthood; however, nearly a quarter of the adolescents reported depressive symptoms that were moderately or highly severe in senior high school and beyond. More than 30% of the participants experienced transitioning into a different developmental trajectory between junior and senior high school. When perceiving a higher level of paternal behavioral control, adolescents categorized in the high-improving class in junior high school would have a higher chance to transition to the moderate-stable class than to HS-low-stable class in senior high school. Adolescent boys and girls did not differ in the probability of transitioning between trajectories across junior and senior high school. However, a clear and consistent pattern of symptoms between late adolescence and early adulthood was not observed. These results help elucidate the heterogeneity and fluidity associated with the development of depressive symptoms between early adolescence and early adulthood in light of school transition among youths in Taiwan.

Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms

In 2 meta-analyses on gender differences in depression in nationally representative samples, we advance previous work by including studies of depression diagnoses and symptoms to (a) estimate the magnitude of the gender difference in depression across a wide array of nations and ages; (b) use a developmental perspective to elucidate patterns of gender differences across the life span; and (c) incorporate additional theory-driven moderators (e.g., gender equity). For major depression diagnoses and depression symptoms, respectively, we meta-analyzed data from 65 and 95 articles and their corresponding national data sets, representing data from 1,716,195 and 1,922,064 people in over 90 different nations. Overall, odds ratio (OR) = 1.95, 95% confidence interval (CI) [1.88, 2.03], and d = 0.27 [0.26, 0.29]. Age was the strongest predictor of effect size. The gender difference for diagnoses emerged earlier than previously thought, with OR = 2.37 at age 12. For both meta-analyses, the gender difference peaked in adolescence (OR = 3.02 for ages 13-15, and d = 0.47 for age 16) but then declined and remained stable in adulthood. Cross-national analyses indicated that larger gender differences were found in nations with greater gender equity, for major depression, but not depression symptoms. The gender difference in depression represents a health disparity, especially in adolescence, yet the magnitude of the difference indicates that depression in men should not be overlooked. (PsycINFO Database Record

Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms

In 2 meta-analyses on gender differences in depression in nationally representative samples, we advance previous work by including studies of depression diagnoses and symptoms to (a) estimate the magnitude of the gender difference in depression across a wide array of nations and ages; (b) use a developmental perspective to elucidate patterns of gender differences across the life span; and (c) incorporate additional theory-driven moderators (e.g., gender equity). For major depression diagnoses and depression symptoms, respectively, we meta-analyzed data from 65 and 95 articles and their corresponding national data sets, representing data from 1,716,195 and 1,922,064 people in over 90 different nations. Overall, odds ratio (OR) = 1.95, 95% confidence interval (CI) [1.88, 2.03], and d = 0.27 [0.26, 0.29]. Age was the strongest predictor of effect size. The gender difference for diagnoses emerged earlier than previously thought, with OR = 2.37 at age 12. For both meta-analyses, the gender difference peaked in adolescence (OR = 3.02 for ages 13-15, and d = 0.47 for age 16) but then declined and remained stable in adulthood. Cross-national analyses indicated that larger gender differences were found in nations with greater gender equity, for major depression, but not depression symptoms. The gender difference in depression represents a health disparity, especially in adolescence, yet the magnitude of the difference indicates that depression in men should not be overlooked. (PsycINFO Database Record

Cumulative family risks across income levels predict deterioration of children's general health during childhood and adolescence

Family is considered an important agent in the health development of children. This process is significant but quite complex because the prevalence of potential risk factors in the family can hinder children’s health. This study examined if multiple family risks might have cumulative effect on children and youth’s health across various levels of household income. The data in this study were drawn from the 2011–2012 U.S. National Survey of Children’s Health (N = 79,601). A cumulative family risk (CFR) index was developed, which included such constructs as single-parenthood, unstable employment, large family, parenting stress, poor maternal education, poor maternal general health and poor maternal mental health. Multiple logistic regression analyses showed that CFR level was significantly related to children and youth’s poor health outcome (p < .001). When poverty levels were considered, however, the impact of CFRs on children and youth’s health was attenuated. The impact of CFRs was higher on children and youth from affluent families than on those from poor families. Overall there was a consistent pattern of trend in the point estimate as well as confidence limits as levels of affluence and numbers of family risk increased although some of the confidence intervals overlapped. Living in disadvantaged families might serve as a protective factor against CFRs possibly through repeated exposure to hardships and subsequent formation of resilience among some of the disadvantaged children.