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

Longitudinal Measurement Invariance of the ASEBA Youth/Adult Self-Reports Across the Transition From Adolescence to Adulthood

The ability to quantify within-person changes in mental health is central to the mission of clinical psychology. Typically, this is done using total or mean scores on symptom measures; however, this approach assumes that measures quantify the same construct, the same way, each time the measure is completed. Without this quality, termed longitudinal measurement invariance, an observed difference between timepoints might be partially attributable to changing measurement properties rather than changes in comparable symptom measurements. This concern is amplified in research using different forms of a measure across developmental periods due to potential differences in reporting styles, item-wording, and developmental context. This study provides the strongest support for the longitudinal measurement invariance of the Anxiety Scale, Depression/Affective Problems: Cognitive Subscale, and the Attention Deficit Hyperactivity Disorder (ADHD) Scale; moderate support for the Depression/Affective Problems Scale and the Somatic Scale, and poor support for the Depression/Affective Problems: Somatic Symptoms Subscale of the Dutch Achenbach System of Empirically Based Assessment Youth Self-Report and Adult Self-Report in a sample of 1,309 individuals (N = 1,090 population-based, N = 219 clinic-based/referred to an outpatient clinic before age 11 years) across six waves of data (mean ages = 11 years at Wave 1 and 26 years at Wave 6).

Hikikomori (prolonged social withdrawal) and co-occurring psychiatric disorders and symptoms in adolescents and young adults: A scoping review

BACKGROUND

Hikikomori, or prolonged social withdrawal, is a clinical condition usually emerging during adolescence or young adulthood, characterized by severe self-isolation in one's home, and often associated with other psychiatric disorders and symptoms.

OBJECTIVE

The study summarized evidence of hikikomori diagnostic criteria, clinical manifestations, and comorbidity with psychiatric disorders and symptoms in adolescents and young adults.

METHODS

A scoping review was conducted following PRISMA guidelines, with four electronic databases searched for original works in English, French, and Italian published since 2010.

RESULTS

A total of 15 studies were selected, 7 involved adolescents, 4 young adults, and 4 participants from both age groups. Most studies relied on the diagnostic criteria proposed for hikikomori inclusion in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Differences in hikikomori and comorbidity profiles were identified between adolescents and young adults.

CONCLUSIONS

Heterogeneity characterized hikikomori diagnostic criteria, comorbidity, demographic and clinical features of the study samples. Studies adopting more homogeneous populations, shared diagnostic criteria, consistent assessment tools and longitudinal designs are needed to better clarify the clinical features of hikikomori in young people.

On Your Own: An Explorative Study on the Psychopathological and Psychosocial Correlates of Hikikomori Symptoms in Dutch Adolescents and Young Adults

Hikikomori is an extreme form of social withdrawal that has been originally described in Japan but that is emergent in many other developed and industrialized countries. The present exploratory study was conducted in The Netherlands and aimed to examine psychopathological and psychosocial correlates of hikikomori symptoms as measured with the Hikikomori Questionnaire-25 (HQ-25) in a convenience population of 122 non-clinical adolescents and young adults and 24 clinically referred young people who were suspected to suffer from autism spectrum disorder (ASD; of which 75% eventually received this DSM-5 diagnosis). The results indicated that higher levels of hikikomori symptoms were associated with higher levels of psychopathological risk factors, higher levels of loneliness as well as a more positive attitude towards being alone, and higher levels of problematic internet use. Furthermore, it was found that hikikomori symptoms were significantly higher in clinically referred participants with suspect ASD than in non-clinical participants. It can be concluded that hikikomori symptoms were present in this sample of young Dutch participants and showed theoretically meaningful relations with other psychological constructs.

Self-isolation of adolescents after Covid-19 pandemic between social withdrawal and Hikikomori risk in Italy

Social withdrawal is a widespread phenomenon among adolescents, presenting significant challenges in understanding its aetiology and dynamics. This study, drawing on data from two cross-sectional surveys conducted in 2019 and 2022 on students in public upper secondary schools, investigates the trend of self-isolation among Italian adolescents before and after the COVID-19 pandemic. The two nationally representative samples comprise 3273 and 4288 participants, respectively, with 46.3% and 41.2% identifying as female, ranging in age from 14 to 19 years. Using Multiple Correspondence Analysis (MCA) and Hierarchical Cluster Analysis (HCA), three distinct profiles of social withdrawal were identified among adolescents: "Social Butterflies", "Friendship-Centric", and "Lone Wolves". Notably, the discovery of a subgroup within the Lone Wolves, composed of adolescents who never meet their friends and whose number has doubled post-pandemic, highlights the chronic nature of the phenomenon that demands urgent intervention. These findings shed light on the increase of self-isolation in Italy, showing the interplay of socio-demographic, psychological, and sociological factors underlying this phenomenon.

Aberrant neural event segmentation during a continuous social narrative in trauma-exposed older adolescents and young adults

Post-traumatic stress and major depressive disorders are associated with "overgeneral" autobiographical memory, or impaired recall of specific life events. Interpersonal trauma exposure, a risk factor for both conditions, may influence how symptomatic trauma-exposed (TE) individuals segment everyday events. The ability to parse experience into units (event segmentation) supports memory. Neural state transitions occur within a cortical hierarchy and play a key role in event segmentation, with regions like the occipital cortex, angular gyrus, and striatum involved in parsing event structure. We examined whether interpersonal trauma exposure was associated with alterations in the cortical hierarchy and striatal activity at neural state transitions in symptomatic TE versus healthy control (HC) individuals. Fifty older adolescents and young adults (29 TE, 21 HC) viewed the film "Partly Cloudy" during functional magnetic resonance imaging. A greedy-state boundary search algorithm assessed the optimal number of events, quality, and segmentation agreement of neural state transitions in the occipital cortex and angular gyrus. Striatal (nucleus accumbens, caudate, and putamen) activity was assessed at occipital and angular gyrus-evoked state transitions. Compared to HCs, TE participants displayed less occipital and greater angular gyrus-evoked optimal number of neural state transitions. TE participants also displayed lower quality of neural state segmentation solutions in occipital and angular cortices compared to HCs. Additionally, TE participants had less putamen activity at angular gyrus-evoked state transitions than HCs. This investigation provides neurobiological insights into aberrant event segmentation in symptomatic TE individuals, shedding light on mechanisms influencing overgeneral memory in trauma-related disorders.

Autism traits, social withdrawal, and behavioral and emotional problems in a Norwegian cohort of adolescents with rare genetic disorders

BACKGROUND

Adolescents with rare genetic disorders represent a population that can be at risk in psychosocial terms. Despite its importance, the association of autism traits and social withdrawal in behavioral and emotional problems in adolescents with rare genetic disorders remains understudied.

AIM

The study aimed to empirically examine the clinical characteristics of adolescents with rare genetic disorders with a behavior theory-driven approach.

METHOD

We investigated the behavioral and emotional problems and current and lifetime autistic traits in a sample of 93 Norwegian adolescents (Mage = 13.2 years, SDage = 2.4, rangeage 10-17, 62.4% females, 37.6% males) with various rare genetic disorders. The adolescents were investigated cross-sectionally utilizing standardized psychometric questionnaires rated by their parents.

RESULTS

More current and lifetime autistic traits and social withdrawal were all associated with more internalizing problems. Further analyses demonstrated that social withdrawal partially mediated the positive association between current autistic traits and internalizing problems. In contrast, social withdrawal fully mediated the positive association between lifetime autistic traits and internalizing problems.

CONCLUSION AND IMPLICATIONS

Our results demonstrate important characteristics of adolescents with rare genetic disorders that may guide clinicians and future interventions. Social withdrawal may be prodromal to internalizing problems such as anxiety and depression. Thus, clinically addressing social withdrawal can represent a means to prevent internalizing problems in adolescents with rare genetic disorders and autistic traits.

Autonomic brain functioning and age-related health concerns

The autonomic nervous system (ANS) regulates involuntary bodily functions such as blood pressure, heart rate, breathing, and digestion, in addition to controlling motivation and behavior. In older adults, the ANS is dysregulated, which changes the ability of the ANS to respond to physiological signals, regulate cardiovascular autonomic functionality, diminish gastric motility, and exacerbate sleep problems. For example, a decrease in heart rate variability, or the variation in the interval between heartbeats, is one of the most well-known alterations in the ANS associated with health issues, including cardiovascular diseases and cognitive decline. The inability to perform fundamental activities of daily living and compromising the physiological reactivity or motivational responses of older adults to moving toward or away from specific environmental stimuli are significant negative consequences of chronic and geriatric conditions that pose grave threats to autonomy, health, and well-being. The most updated research has investigated the associations between the action responsiveness of older adults and the maintenance of their physiological and physical health or the development of mental and physical health problems. Once autonomic dysfunction may significantly influence the development of different age-related diseases, including ischemic stroke, cardiovascular disease, and autoimmune diseases, this review aimed to assess the relationship between aging and autonomic functions. The review explored how motivational responses, physiological reactivity, cognitive processes, and lifelong developmental changes associated with aging impact the ANS and contribute to the emergence of health problems.

Motivations for Social Withdrawal, Mental Health, and Well-Being in Emerging Adulthood: A Person-Oriented Approach

Emerging adults seek solitude because of different underlying motivational and emotional processes. The current short-term longitudinal study aimed to: (1) identify subgroups of socially withdrawn emerging adults characterized by different motivations for solitude (shyness, unsociability, social avoidance) and affect (positive, negative); and (2) compare these subgroups in terms of indices of internalizing difficulties and life-satisfaction. Participants were N = 348 university students (Mage = 21.85 years, SD = 3.84) from Italy, who completed online questionnaires at two-time points separated by three months. Results from a latent profile analysis (LPA) suggested three distinct subgroups characterized by different social withdrawal motivations (i.e., shy, unsociable, and socially avoidant), as well as a non-withdrawn subgroup (characterized by low social withdrawal motivations, low negative affect, and high positive affect). Among the results, the socially avoidant subgroup reported the highest levels of social anxiety, whereas the avoidant and shy subgroups reported the highest loneliness and lowest life satisfaction. The unsociable subgroup appeared to be the most well-adjusted subgroup of socially withdrawn emerging adults and reported similar levels of life satisfaction as the non-withdrawn subgroup. Our findings confirmed the heterogeneity of emerging adults' experiences of solitude, with different motivations for social withdrawal appearing to confer a differential risk for maladjustment.

A cross-lagged twin study of emotional symptoms, social isolation and peer victimisation from early adolescence to emerging adulthood

BACKGROUND

Emotional symptoms, such as anxiety and depressive symptoms, are common during adolescence, often persist over time, and can precede the emergence of severe anxiety and depressive disorders. Studies suggest that a vicious cycle of reciprocal influences between emotional symptoms and interpersonal difficulties may explain why some adolescents suffer from persisting emotional symptoms. However, the role of different types of interpersonal difficulties, such as social isolation and peer victimisation, in these reciprocal associations is still unclear. In addition, the lack of longitudinal twin studies conducted on emotional symptoms during adolescence means that the genetic and environmental contributions to these relationships during adolescence remain unknown.

METHODS

Participants (N = 15,869) from the Twins Early Development Study completed self-reports of emotional symptoms, social isolation and peer victimisation at 12, 16 and 21 years old. A phenotypic cross-lagged model examined reciprocal associations between variables over time, and a genetic extension of this model examined the aetiology of the relationships between variables at each timepoint.

RESULTS

First, emotional symptoms were reciprocally and independently associated with both social isolation and peer victimisation over time, indicating that different forms of interpersonal difficulties uniquely contributed to emotional symptoms during adolescence and vice versa. Second, early peer victimisation predicted later emotional symptoms via social isolation in mid-adolescence, indicating that social isolation may constitute an intermediate pathway through which peer victimisation predicts longer-term emotional symptoms. Finally, individual differences in emotional symptoms were mostly accounted for by non-shared environmental factors at each timepoint, and both gene-environment and individual-specific environmental mechanisms were involved in the relationships between emotional symptoms and interpersonal difficulties.

CONCLUSIONS

Our study highlights the necessity to intervene early in adolescence to prevent the escalation of emotional symptoms over time and to consider social isolation and peer victimisation as important risk factors for the long-term persistence of emotional symptoms.

"Alone Again, Naturally": Mental Health Problems, Level of Personality Functioning, Social Withdrawal and Loneliness in Adolescents Admitted as Acute Inpatients in the Aftermath of the COVID-19 Pandemic

(1) Background: Adolescents admitted as acute inpatients belong to a particularly psychosocially vulnerable population. This study aimed to examine the clinical characteristics of an affected population in Germany using a theory-based approach. (2) Methods: We assessed the mental health problems, levels of personality functioning, and the severity of social withdrawal and loneliness in n = 62 adolescents admitted to an acute psychiatric inpatient unit. Cases were investigated cross-sectionally utilizing standardized psychometric questionnaires from the perspective of the patients and clinical experts. (3) Results: Mental health, level of impaired personality functioning, social withdrawal, and loneliness were all positively associated with the need for acute admission. Further analyses revealed that the level of personality functioning fully mediated the positive association between social withdrawal and mental health problems. In contrast, level of personality functioning only partially mediated the positive association between loneliness and mental health problems. (4) Conclusions: Our results suggest that more impairment in personality functioning might lead to poorer mental health when adolescents socially withdraw in the aftermath of the COVID-19 pandemic. Loneliness, social withdrawal, and the level of personality functioning may help identifying essential characteristics of adolescents admitted to acute psychiatric inpatient units and guide the development of specific interventions.

Trajectories of social withdrawal and social anxiety and their relationship with self-esteem before, during, and after the school lockdowns

The closure of schools during the COVID-19 pandemic affected adolescents' social withdrawal and social anxiety. Yet, self-esteem may have acted as a protective factor during this period. This study aimed to compare the trajectories of social withdrawal and social anxiety before (Year 1), during (Year 2 and 3), and after (Year 4) the closure of schools imposed by the COVID-19-related lockdowns, and to investigate the association of self-esteem with these trajectories. Participants were 844 (50.6% boys) Portuguese adolescents (mean age 12.70 years, SD = 1.14). The Social and Emotional Competencies Evaluation Questionnaire (QACSE) was used to assess social withdrawal and social anxiety, while The Global Self-Esteem scale of the Self-Description Questionnaire II was used to measure self-esteem. Growth curve analysis showed that social withdrawal and social anxiety had more negative trajectories during the year in which the school closures occurred. In addition, adolescents reported higher social withdrawal after the lockdowns than before the pandemic. Higher self-esteem was associated with a more positive trajectory in social withdrawal. Therefore, the results showed the negative of impact of the closure of schools on adolescents' social anxiety and social withdrawal, and that self-esteem was a protective factor during these challenging and adverse events.

Contemporary Hermits: A Developmental Psychopathology Account of Extreme Social Withdrawal (Hikikomori) in Young People

Although it is widely accepted that human beings have an ingrained 'need to belong,' there seem to be a substantial subset of young people who seclude themselves for most of the time at home and no longer engage in education or work, ultimately withdrawing from participation in society. In Japan, this phenomenon has been labeled as 'hikikomori,' but given its global presence it may be preferable to use the term 'extreme social withdrawal' (ESW). In this qualitative review, we provide a description and definition of ESW, provide figures on its prevalence, and discuss a number of associated concepts, including loneliness and "aloneliness," school absenteeism and dropout, the 'new' developmental stage of adultolescence, and the labor force categories of freeter ('freelance arbeiter') and NEET (a young person not in employment, education, or training). The core of the paper is focused on the origins of ESW in young people and provides a narrative overview of relevant etiological factors, such as aberrant brain processes, unfavorable temperament, psychiatric conditions, adverse family processes including detrimental parenting, negative peer experiences, societal pressures, and excessive internet and digital media use, which are all placed within a comprehensive developmental psychopathology framework. We will close with a discussion of possible interventions for young people with ESW and formulate a guideline that describes (the temporal order of) various components that need to be included in such a treatment.

Examining the relationship between social withdrawal motivations and symptoms of hikikomori

Objective: This study aimed to examine the association between social withdrawal motivations (peer isolation, shyness, unsociability, low mood, and avoidance) and symptoms of hikikomori using both variable- and person-oriented analyses.Method: Adolescents (N = 212) participated in this cross-sectional study. Data were collected using the Social Withdrawal Motivations Scale and the Avoidance subscale of the Child Social Preference Scale-Revised, the 25-item Hikikomori Questionnaire, the Personality Inventory for the DSM-5 Brief Form, and the Interpersonal sensitivity subscale of the Brief Symptom Inventory.Results: Path analysis revealed that peer isolation, shyness, unsociability, and avoidance were associated with symptoms of hikikomori while covarying for age, sex, maladaptive personality, and interpersonal sensitivity. Cluster analysis based on social withdrawal motivations identified four subtypes of adolescents. The group with high social withdrawal motivations showed the highest level of overall personality dysfunction and interpersonal sensitivity. Additionally, the group with high social withdrawal motivations and the group with high avoidance demonstrated higher symptoms of hikikomori compared to the other two groups, after accounting for the effects of the covariates.Conclusions: The findings highlight that the evaluation of co-occurrent social withdrawal motivations may improve the ability to identify those adolescents most in need of support.

The Development of Shyness from Late Childhood to Adolescence: A Longitudinal Study of Mexican-origin Youth

Shyness, the tendency to be inhibited and uncomfortable in novel social situations, is a consequential personality trait, especially during adolescence. The present study examined the development of shyness from late childhood (age 10) through adolescence (age 16) using data from a large, longitudinal study of Mexican-origin youth (N = 674). Using both self- and mother-reports of shyness assessed via the Early Adolescent Temperament Questionnaire-Revised, we found moderate to high rank-order stabilities across two-year intervals and a mean-level decrease in shyness from age 10 to 16. Anxiety and depression were associated with higher initial levels of shyness, and anxiety was associated with greater decreases in shyness from age 10 to 16. Contrary to predictions, neither nativity (country of birth) nor language proficiency (English, Spanish) was associated with the development of shyness across adolescence. Thus, youth generally decline in shyness during adolescence, although there is substantial individual variability in shyness trajectories.

Examining the hikikomori syndrome in a French sample of hospitalized adolescents with severe social withdrawal and school refusal behavior

While the term hikikomori (HKM) has spread internationally to describe a chronic and severe form of social withdrawal, its place in current nosography and its transposition into non-Asian cultures are still debated. A retrospective chart review was conducted to determine the rate and the clinical profiles of HKM among a French sample of adolescent inpatients. Data were obtained from 191 adolescents aged 12-18 years (M = 15.0, 44% boys) consecutively admitted in two inpatient units from January 2017 to December 2019. Using a retrospective diagnosis of HKM based on Teo and Gaw's criteria, we compared socio-demographic characteristics, clinical features, and treatment outcomes between HKM patients and those with other forms of social withdrawal and/or school refusal (SW/SR). At admission, 7% of participants met HKM criteria (n = 14, M = 14.3, 64% boys), one out of six adolescents with SW/SR. Among those with SW/SR, HKM + vs. HKM- participants had higher rates of anxiety disorder (Odd Ratio, OR = 35.2) and lower disruptive behavioral disorder (OR = 0.03). A minority of the participants with anxiety and depressive disorders met the HKM criteria (respectively, 15% and 9%), but those with HKM had a longer duration of symptoms, longer hospitalization, and required more daily care facilities at discharge compared to HKM-. While HKM syndrome could not be delimitated from anxiety disorder, it was associated with specific clinical features and treatment outcomes. The clinical characteristics observed were consistent with the features reported in Asian HKM adults, supporting face validity of this clinical concept in adolescent inpatients with different cultural contexts.

The Italian version of the mobile phone problematic use scale for adults (MPPUS): A validation study

The Mobile Phone Problematic Use Scale (MPPUS) is a self-report measure developed to identify the problematic use of mobile phones (PSU) among adults. The purpose of this study was to create an Italian version of this scale. A sample of 568 Italian adults completed the MPPUS, presented in association with another validated scale for the assessment of smartphone addiction. We carried out exploratory factor analyses on the MPPUS. Findings emphasised that the Italian version of the MPPUS fits a bi-factor model, in which the general factor 'PSU' was found, including two additional specific factors (i.e., 'Withdrawal and social aspects' and 'Craving and escape from other problems'). The MPPUS was correlated with the Smartphone Addiction Scale short version. With respect to criterion-oriented validity, the MMPUS was also evaluated in relation to socio-demographic variables (i.e., age and gender). The internal consistency and temporal stability of the scales (test-retest assessment after three months) were confirmed.

[Effect of Acculturative Stress on Multicultural Adolescents' Life Satisfaction: Sequential Multiple Mediating Effects of Bicultural Acceptance Attitude, Self-Esteem, and Social Withdrawal -Using the 2016 Multicultural Adolescents Panel Study]

PURPOSE

This study determined acculturative stress' effect on the life satisfaction of multicultural adolescents based on Roy's Adaptation Model and some earlier studies. Further, it examined the sequential multiple mediating effects of bicultural acceptance attitude, self-esteem, and social withdrawal on life satisfaction.

METHODS

Participants included 1,163 multicultural adolescents who participated in the sixth Multicultural Adolescents Panel Study. A hypothesis test was conducted using Hayes' Process Macro Model 81.

RESULTS

Life satisfaction increased with a decline in acculturative stress. Each of bicultural acceptance attitude, self-esteem, and social withdrawal had a single mediating effect on the relationship between acculturative stress and life satisfaction in multicultural adolescents. The sequential multiple mediating effects of bicultural acceptance attitude and self-esteem were confirmed significant after their impact on the relationship between acculturative stress and life satisfaction was analyzed. Bicultural acceptance attitude and social withdrawal were found to have a significant sequential multiple mediating effect on the relationship, as well.

CONCLUSION

This study's results demonstrate that acculturative stress reduction is critical to improving multicultural adolescents' life satisfaction. Bicultural acceptance attitude, self-esteem, and social withdrawal have a single mediating or sequential multiple mediating effect on the relationship between multicultural adolescents' acculturative stress and life satisfaction. The findings, which highlight mediating effects, indicate that by increasing bicultural acceptance attitude and self-esteem, and reducing social withdrawal, multicultural adolescents' life satisfaction can be improved.

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.

Identifying Clusters of Adolescents Based on Their Daily-Life Social Withdrawal Experience

Social withdrawal is often presented as overall negative, with a focus on loneliness and peer exclusion. However, social withdrawal is also a part of normative adolescent development, which indicates that groups of adolescents potentially experience social withdrawal differently from one another. This study investigated whether different groups of adolescents experienced social withdrawal in daily life as positive versus negative, using experience sampling data from a large-scale study on mental health in general population adolescents aged 11 to 20 (n = 1913, M_Age = 13.8, SD_Age = 1.9, 63% female) from the Flemish region in Belgium. Two social withdrawal clusters were identified using model-based cluster analysis: one cluster characterized by high levels of positive affect and one cluster characterized by high levels of negative affect, loneliness and exclusion. Logistic regression showed that boys had 66% decreased odds of belonging to the negative cluster. These results show that daily-life social withdrawal experiences are heterogeneous in adolescence, which strengthens the view that, both in research and clinical practice, social withdrawal should not be seen as necessarily maladaptive.

Effects of Self-Concept on Narcissism: Mediational Role of Perceived Parenting

An increase in narcissism has been reported by experts over the years. Narcissists bring a lot of negative consequences to themselves and to the people around them. This study investigates that perceived parenting leads to the development of inflated, unstable self-concept. The inflated self-concept lays the framework for the development of narcissistic traits among individuals; perceived parenting affects this relationship. A sample of 628 adults was taken from North Cyprus through purposive sampling. Scales for perceived parenting, self-concept, and narcissism were administered. Results showed that the statistically significant variance in the self-concept is explained by perceived parenting. Both mothers and fathers contributed significantly to the development of inflated self-concept. Moreover, multiple linear regression results showed a higher significant variance in narcissistic traits due to self-concept compared with perceived parenting. Mediational tests also showed that high levels of narcissistic traits were indirectly related to self-concept through perceived parenting. The study findings have challenged the notion of only mothers being responsible for narcissistic traits among their children. The study results also suggest that targeting self-concept in individuals with narcissistic traits may be a good directive for therapeutic interventions.

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.

Exploring the temporal associations between avoidance behavior and cognitions during the course of cognitive behavioral therapy for clients with symptoms of social anxiety disorder

OBJECTIVES

In cognitive behavioral therapy (CBT) for social anxiety disorder (SAD), avoidance behavior (AB) and cognitions (COG) are two important targets of intervention, but so far no studies have directly examined their relative importance. By means of cross-lagged panel models (CLPM), we examined their temporal associations and impacts on outcome in clients with symptoms of SAD while addressing typical methodological challenges.

METHOD

We used data from the first six therapy sessions in a sample of 428 primary care clients (mean [SD] age = 34.6 [12.2], 34.3% men), participating in the Prompt Mental Health Care trial. Session-by-session data was collected on AB, COG, depression and general anxiety. Competing multiple indicator CLPMs were tested.

RESULTS

The Random Intercept-CLPM provided best fit, and indicated that AB predicted COG at subsequent time points (.39 ≤ β  ≤ .42 for T2-T5, p  < .05), but not vice versa. In addition, AB, but not COG, predicted clients' general anxiety score at subsequent time points. Results were both robust to the inclusion of depressive symptoms as a within-level covariate, and sensitivity tests for stationarity and missing data assumptions.

CONCLUSION

Targeting avoidance behavior for primary care clients with symptoms of SAD may be more vital for the optimal effect of CBT than targeting cognitions. Methodological considerations and limitations of the study are discussed.Trial registration: ClinicalTrials.gov identifier: NCT03238872.

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.

Sex differences in adolescent mental health profiles in South Korea

Accumulating evidence indicates that sex of adolescents is a major factor affecting mental health. This study aimed to compare mental health profiles and longitudinal effects of various factors on mental health between male and female adolescents using the Korean Children and Youth Panel Survey. Results showed that females were more depressed, aggressive, and likely to develop somatic symptoms than males, while males exhibited more attention deficits than females. Moreover, abusive parenting behavior was associated with a lower level of mental health in both male and female adolescents. In addition, we found significant differences in the effects of individual factors (subjective health status and smartphone addiction), family-related factors (living with both parents, working mother, and neglectful parenting behavior), and school-related factors (school adjustment and satisfaction with grades) on mental health between male and female adolescents. These findings indicate sex differences in adolescent mental health profiles in South Korea. Further studies are needed to develop comprehensive mental health strategies that consider personal, family, and school-related factors and sex differences.

Adolescent social withdrawal, parental psychological control, and parental knowledge across seven years: A developmental cascade model

INTRODUCTION

Social withdrawal can be problematic for adolescents, increasing the risk of poor self-efficacy, self-esteem, and academic achievement, and increased levels of depression and anxiety. This prospective study follows students across adolescence, investigating links between social withdrawal and two types of parenting hypothesized to impact or be reactive to changes in social withdrawal.

METHODS

Adolescent social withdrawal and parenting were assessed across seven years in a U.S. sample, beginning when students were in 6th grade and ending in 12th grade. The sample consisted of 534 adolescents (260 girls and 274 boys, 82% Euro- and 16% African-American). Social withdrawal was assessed in four grades using at least two informants (teachers, mothers, and/or adolescents). Mothers' and fathers' psychological control and monitoring-related knowledge were assessed by adolescents at two time points. A developmental cascade analysis was conducted using structural equation modeling to assess how withdrawal and control-related parenting impact each other transactionally over time. Analyses included a test for gender differences in the model.

RESULTS

The cascade model revealed that, controlling for previous levels of social withdrawal and parenting, earlier social withdrawal positively predicted psychological control and negatively predicted monitoring knowledge, and earlier parental psychological control-but not monitoring knowledge-predicted later social withdrawal. No adolescent gender differences were identified in the associations between social withdrawal and parental knowledge.

CONCLUSIONS

This study offers insight into the mechanisms by which adolescents become more or less withdrawn over time, and suggests psychological control as a point of psychoeducation or intervention for parents.