Different trajectories of depressive symptoms in children and adolescents: predictors and differences in girls and boys

Trait anxiety predicting the developmental trajectories of depression symptoms in children: The mediating role of attentional control

Trait anxiety and attentional control are important factors related to depression symptoms. The study investigated how trait anxiety and attentional control predicted the trajectories of depression symptoms during the transition into early adolescence. The mediating effect of attentional control on the relationship of trait anxiety to the trajectories of depression symptoms was also examined. Children of 9 to 10 years were recruited at Time 1. Trait anxiety, attentional control, and depression symptoms were assessed at Time 1. Depression symptoms were measured at three follow-up assessments across 18 months. Latent class growth modeling revealed high (14.4%) and low (85.6%) trajectories of depression symptoms. Higher trait anxiety and lower attentional control predicted a higher likelihood of showing the trajectory of high depressive symptoms. Attentional control mediated the relationship of trait anxiety to the trajectory membership of depression symptoms. The findings had important implications for the association of trait anxiety with the trajectory membership of depression symptoms and highlighted the importance of attentional control in the development of depression symptoms for children with high trait anxiety.

The Social Failure Model: Do Classroom Norms Play a Role in the Development of Antisocial Behavior and Depressive Symptoms?

This study examined the moderating role of descriptive and status norms in the stability of youth's antisocial behavior, and the link between initial antisocial behavior and the development of depressive symptoms over the course of one academic year, while controlling for initial depression levels. A total of 1081 students (51.06% girls; grades 4 through 6) in schools in low to average socio-economic status neighborhoods completed self-reports and a peer nomination inventory in the fall (T1) and spring (T2) of one year. Descriptive norms were operationalized as the classroom- and sex-specific mean level of antisocial behavior. Status norms were operationalized as the classroom- and sex-specific correlation between antisocial behavior and social preference. Descriptive norms moderated the link between T1 and T2 antisocial behavior, such that youth exhibiting high levels of antisocial behavior showed a greater increase in antisocial behavior in classrooms where descriptive norms strongly favored such behavior (i.e., + 1 SD) than in classrooms with neutral or weak descriptive norms (i.e., - 1 SD). Status norms moderated the association between T1 antisocial behavior and T2 depressive symptoms, such that youth with high levels of antisocial behavior had higher depressive symptoms in classrooms where status norms disfavored antisocial behavior than in classrooms with neutral or favorable norms. No moderating effects of sex or grade were observed. These results suggest that both descriptive norms and status norms play important, albeit distinct, roles in exacerbating youth's depressive symptoms and antisocial behavior, but they may also mitigate these same outcomes in favorable contexts.

The effect of childhood depression trajectories on sugar-sweetened beverage habit trajectories in adolescence: Exploring sleep problems as a mediator

Although depression has been linked to the habit of consuming sugar-sweetened beverages (SSBs), little is known about their long-term relationships and the mediating role of sleep problems. This study examines the associations between childhood depressive symptoms trajectories and adolescent SSB-habit trajectories and whether these associations were mediated by sleep problems. Data came from 1560 adolescents participating in a longitudinal study across grades 1 through 12 in northern Taiwan. Group-based trajectory modeling was used to identify development of childhood depressive symptoms and an SSB habit in adolescence. Multinomial logistic regression was conducted to examine the influence of childhood depressive symptoms and adolescent SSB habit. Mediation analysis was conducted to test whether sleep problems mediated the associations examined. Four distinct trajectories of childhood depressive symptoms were identified: low-stable (30.79%), moderate-stable (42.32%), increasing (12.29%), and high-stable (11.60%). Three distinct trajectories of SSB habit in adolescence were identified: low-stable (44.32%), increasing (15.02%), and high-stable (40.65%). Children who had moderate-stable (aOR = 1.35; CI: 1.04-1.77), high-stable (aOR = 2.01; CI: 1.28-3.15), or increasing (aOR = 1.97; CI: 1.26-3.06) trajectories of depressive symptoms relative to those in the low-stable group were significantly more likely to belong to the high-stable trajectory of SSBs than to the low-stable SSBs group. The Z-mediation test showed that sleep problems significantly mediated the associations between trajectories of childhood depressive symptoms and trajectories of SSBs during adolescence (all p < 0.05). Childhood depressive symptoms conferred risks for adolescent SSB habits; and the effects were seen, in part, through increasing sleep problems.

Do community-related traumatic events affect academic outcomes among adolescents? Quasi-experimental evidence from the Sewol disaster in South Korea

The sinking of the South Korean ferry Sewol in April 2014 claimed a total of 304 lives. Among the victims were 250 students from Dan-won High School in the city of Ansan and 11 of their teachers. For the residents of Ansan, the tragedy marked the beginning of widespread psychological distress and overwhelming grief. Exploiting the disaster's quasi-experimental nature, we employ a difference-in-differences (DID) strategy to measure its impact on the academic performance of Ansan's high school students in 5 major subjects. Using peers from Ansan's neighboring cities as the control group, our results reveal that the disaster impaired performances particularly in mathematics and natural science, a finding that is more pronounced for female students. Our results highlight that it is of uttermost importance to provide comprehensive psychological support and interventions to traumatized students but also to the communities they live in to minimize adverse effects on educational attainment.

Associations between social loneliness trajectories and chronotype among adolescents

Late chronotype during adolescence is a critical risk factor for poor physical and mental health among adolescents. While social loneliness is confirmed to negatively influence sleep behaviors, the long-term effect of social loneliness on chronotype remains unknown. This study aims to investigate whether social loneliness trajectories from middle childhood to adolescence are associated with chronotype in late adolescence and examine the potential sex differences in these associations. Data were obtained from 2398 adolescents who participated in the Child and Adolescent Behaviors in Long-Term Evolution project. Chronotype was calculated as the midpoint of sleep on free days adjusted for sleep debt. Group-based trajectory modeling and multiple linear regression were employed to establish social loneliness trajectories and determine their associations with chronotype. Social loneliness trajectories were significantly associated with chronotype and varied by sex. Specifically, boys following a high-decreasing trajectory had earlier chronotype during late adolescence than did those following a low-decreasing trajectory (B =  - 0.07; p < 0.05). By contrast, girls following a low-to-moderate-increasing trajectory exhibited later chronotype than did those following a low-stable trajectory (B = 0.07; p < 0.01). Social loneliness trajectories, especially those displaying significant fluctuations over time, are critical indicators influencing chronotype among adolescents. Furthermore, these trajectories and their associations with chronotype display sex differences. These findings highlight the need for early interventions for psychological factors such as social loneliness to ensure that the late chronotype can be prevented. In addition, sex variations must be considered.

Profiles and Transitions of Non-Suicidal Self-Injury and Depressive Symptoms among Adolescent Boys and Girls: Predictive Role of Bullying Victimization

Although non-suicidal self-injury (NSSI) and depressive symptoms often co-occur, as well as display distinct profiles in different genders, few studies examined the gender-specific profiles and transitions of NSSI and depressive symptoms among adolescents and the role of bullying victimization on their profiles and transitions. This study examined the profiles and transitions of NSSI and depressive symptoms for Chinese adolescent boys and girls separately, along with the predictive role of bullying victimization in subgroup memberships and transitions. A total of 3510 adolescents (52.9% boy, M age = 13.36, SD = 0.50) participated in two waves of the study over six months. The results indicated that four and three profiles identified for girls and boys separately. Adolescents in at-risk profiles showed varying degrees of transition. Adolescents with more bullying victimization were more likely to belong or transition to at-risk profiles for both genders, and bullying victimization exacerbated girls transitioning into co-occurring high profile but not in boys. The findings indicate distinct profile and transition patterns of NSSI and depressive symptoms, as well as different risk role of bullying victimization on their profiles and transitions in boys and girls, highlighting the importance of gender differences in understanding co-occurring and transitional nature of NSSI and depressive symptoms and the risk role of bullying victimization, informing effective strategies for prevention and intervention.

[Sex as a moderating variable of internalizing and externalizing symptomatology in childhood]

OBJECTIVE

One in one hundred minors has some mental health problem. Symptomatology varies according to gender. Most research has been conducted with the general population. The objective of this paper was to analyze the moderating role of sex in the presence of internalizing (emotional disorders, anxiety and depression) and externalizing symptomatology (behavioral disorders and hyperactivity) in childhood, as well as to compare the general population with the clinical population.

METHODS

A descriptive cross-sectional study was conducted with 552 boys and girls between ten and twelve years of age, 94 mental health patients and 458 schoolchildren. Participants completed self-report measures: Strengths and Difficulties Questionnaire (SDQ-Cas), Modified Depression Scale (MDS) and a sociodemographic information questionnaire. For data analysis, descriptive statistics and multivariate and univariate mean comparisons were performed by parametric and re-sampling procedures.

RESULTS

Statistically significant differences were observed between clinical and school population groups in externalizing, internalizing and depressive symptomatology (p<0.001). No sex differences were found in externalizing and depressive symptomatology. Sex differences were found in internalizing symptoms (p<0.001, pboot<0.001) as well as group interaction effects (p=0.016), girls had higher scores than boys, with greater differences in the clinical group (p<0.001, pboot=0.003).

CONCLUSIONS

Research with mental health patients is essential to verify the existence or not of differences with the general population as well as differences by sex, which will allow adapting preventive and intervention strategies to each case.

Changes in Depression Among Adolescents: A Multiple-Group Latent Profile Transition Analysis

Background

Depression of adolescents is an important public health problem. Persistent depression will become a huge hidden danger of individual mental health development. It is important to study the change mechanism of adolescents' depression.

Methods

A total of 563 males and 739 females aged 11-19 years reported their depression. 1302 adolescents participated in a short-term 6-month longitudinal study. They were contacted every three months for two follow-up tests (T2 and T3). Participants completed internet addiction test, self-rating anxiety scale and self-rating depression scale. Multiple-group latent profile transition analysis (MLPTA) was used to identify meaningful subgroups and transitions between groups across time. Covariates (anxiety and internet addiction) were used to analyze the influencing factors.

Results

The results showed that: (1) There are three categories of adolescents' depression, namely no-depression group, low-depression-mountain group and low-depression-hill group. (2) The depression of the subjects showed a trend of improvement, but the proportion of low-depression-mountain group is relatively high at three time points (0.44, 0.59, and 0.30). (3) The transition probability between the low-depression-mountain group and the no-depression group is large, which suggests the low-depression-mountain group can easily convert into the no-depression group, but the transition probability from low-depression-hill group to other groups is relatively low and stable, which suggests the low-depression-hill group is not easily converted into the no-depression group. (4) Both anxiety and internet addiction affect the development of adolescents' depression across three time points. Anxiety played a significant role in affecting female adolescents' depression, while internet addiction played a significant role in affecting male adolescents' depression.

Conclusion

This study demonstrated a transition pattern in adolescents' depression. We should pay more attention to the low-depression-mountain group and try to do their mental health well. Adolescents' Depression changes rapidly with anxiety and internet addiction for different genders, which suggests that some interventions are needed.

Gene-Environment Interplay Linking Peer Victimization With Adolescents' Trajectories of Depressive Symptoms

OBJECTIVE

This study examined to what extent genetic and environmental factors explain-either additively or interactively with peer victimization-different trajectories of adolescents' depressive symptoms and whether genetic factors related to distinct trajectories are correlated with peer victimization.

METHOD

Participants included 902 twins (52% girls) who self-reported peer victimization and depressive symptoms in grades 6, 7, 8, 9, and 11.

RESULTS

Growth mixture modeling revealed 3 trajectories of depressive symptoms: low (69.2% of participants), increasing (19.5%), and high-decreasing-increasing (11.3%). Biometric modeling showed that, for both sexes, genetic factors explained roughly half (52.6%, 47.5%) of the probability of following either a low or an increasing trajectory. Genetic influences (41%) were also observed for the high-decreasing-increasing trajectory, albeit only for girls. Nonshared environmental influences explained the remaining variances, along with shared environmental influences (27%) on the high-decreasing-increasing trajectory. Only for the low and the increasing trajectories, nonshared environmental influences increased with more frequent peer victimization (b_low = 0.206, 95% CI [0.094, 0.325]; b_increasing = 0.246, 95% CI [0.143, 0.356]). Moreover, peer victimization was associated with a lower probability of a low trajectory and a higher probability of an increasing or high-decreasing-increasing trajectory, and these associations were mostly explained by common underlying genetic factors.

CONCLUSION

Youth expressing (partly inherited) depressive symptoms may be at risk of peer victimization. However, increasing depressive symptoms in victims may be mitigated by other environmental factors except for those who enter adolescence with already high levels of depressive symptoms.

Trajectories of depression for Latino immigrant adolescents: The influence of individual, family, and sociocultural factors

Latino immigrant adolescents represent a high-risk group for developing depression. Such risk for depression becomes more salient in emerging destination contexts (e.g., Oregon) where immigrant youth face considerably more stressors compared to traditional contexts (e.g., Texas, New York, and California). However, no study to date has considered how depression unfolds over time among Latino immigrant youth in emerging contexts. Using data from a three-wave prospective longitudinal design across 3 years, we employed latent growth curve (LGC) modeling to assess depression trajectories among 217 Latino immigrant families in the emerging context of western Oregon. Moreover, we assessed the influence of salient predictors on these trajectories across individual (gender and time in U.S. residency), family (family cultural stress, effective parenting practices, parent depression), and sociocultural (ethnic discrimination) levels. Results from LGC revealed that youth, on average, followed a decreasing trajectory of depression. Furthermore, identifying as female and higher levels of parent depression significantly predicted higher baseline levels of youth depression. No significant predictors emerged for the slope. However, follow-up analyses from multiple-group LGCs found that, whereas males were stable in their trajectories, females exhibited significantly more variability in their initial levels of depression and slopes over time. Moreover, when considered separately, predictors were significant only for females such that parent depression predicted higher baseline depression scores, and family cultural stress predicted a more slowly decreasing slope. Results suggest that Latina immigrant females are more variable in their depression patterns than males and may be more sensitive to family-related stressors that contribute to depression. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Trajectories of stressful life events and long-term changes in mental health outcomes, moderated by family functioning? the TRAILS study

PURPOSE

We assessed the association between trajectories of stressful life events (SLEs) throughout adolescence and changes in mental health from childhood to young adulthood. Further, we assessed whether family functioning moderated this association.

METHODS

Data of the first six waves of the TRAILS study (2001-2016; n = 2229) were used, a cohort followed from approximately age 11 to 23. We measured SLEs (death of a family member or other beloved one, delinquency, moving, victim of violence, parental divorce, and sexual harassment) at ages 14, 16 and 19. Family functioning was measured at all six time points using the Family Assessment Device (FAD), and mental health was measured through the Youth/Adult Self-Report at ages 11 and 23. Latent class growth analyses (LCGA) were used to examine longitudinal trajectories and associations.

RESULTS

We identified three SLE trajectories (low, middle, high) throughout adolescence, and found no significant associations between these trajectories and changes in mental health from childhood to young adulthood. Family functioning and SLE trajectories were significantly associated, however, the association of SLE trajectories and changes in mental health was not modified by family functioning. Mental health problems at age 11 increased the likelihood of high SLE trajectories during adolescence, and of experiencing negative family functioning.

CONCLUSION

Experiencing SLEs throughout adolescence does not have a direct impact on changes in mental health from childhood to young adulthood, but early adolescence mental health problems increase the likelihood of experiencing SLEs.

The role of family and peer factors in the development of early adolescent depressive symptoms: A latent class growth analysis

Few studies have explored the trajectories of Chinese early adolescent depressive symptoms or comprehensively considered the factors of family and peers. The present study aimed to identify the trajectories of depressive symptoms in early adolescence using a school-based sample assessed in three waves. The study also examined whether family and peer factors were significant predictors. A total of 586 Chinese primary and middle school students participated in the survey. A growth mixture model was used to find the trajectories of depressive symptoms, and multinominal logistic regression was used to identify the predictors. Three trajectories were identified, including a stable-low class, an increasing class, and a high-decreasing class. Results indicated that gender, parental psychological aggression and neglect, parental psychological control, traditional bullying/cyberbullying victimization, and friendship quality were significant predictors. However, witnessing intimate partner violence, parental behavior control, and traditional bullying/cyberbullying perpetration could not significantly predict the trajectories. The findings of this study can provide an empirical basis for teachers and clinical interveners to determine different development trajectories of depressive symptoms and carry out prevention and intervention.

Prediction of the trajectories of depressive symptoms among children in the adolescent brain cognitive development (ABCD) study using machine learning approach

BACKGROUND

Depression often first emerges during adolescence and evidence shows that the long-term patterns of depressive symptoms over time are heterogeneous. It is meaningful to predict the trajectory of depressive symptoms in adolescents to find early intervention targets.

METHODS

Based on the Adolescent Brain Cognitive Development Study, we included 4962 participants aged 9-10 who were followed-up for 2 years. Trajectories of depressive symptoms were identified by Latent Class Growth Analyses (LCGA). Four types of machine learning models were built to predict the identified trajectories and to obtain variables with predictive value based on the best performance model.

RESULTS

Of all participants, 536 (10.80%) were classified as increasing, 269 (5.42%) as persistently high, 433 (8.73%) as decreasing, and 3724 (75.05%) as persistently low by LCGA. Gradient Boosting Machine (GBM) model got the highest discriminant performance. Sleep quality, parental emotional state and family financial adversities were the most important predictors and three resting state functional magnetic resonance imaging functional connectivity data were also helpful to distinguish trajectories.

LIMITATION

We only have depressive symptom scores at three time points. Some valuable predictors are not specific to depression. External validation is an important next step. These predictors should not be interpreted as etiology and some variables were reported by parents/caregivers.

CONCLUSION

Using GBM combined with baseline characteristics, the trajectories of depressive symptoms with two years among adolescents aged 9-10 years can be well predicted, which might further facilitate the identification of adolescents at high risk of depressive symptoms and development of effective early interventions.

[Adverse childhood experiences, sociodemographic characteristics, and depressive symptoms in adolescents in a municipality in Rio de Janeiro, Brazil]

The study aimed to identify patterns in adverse childhood experiences among teenage schoolchildren in a municipality (county) in Rio de Janeiro State, Brazil, according to sociodemographic characteristics (sex, skin color, and socioeconomic status) and depressive symptoms. It adopted a cross-sectional design with a sample of 1,117 teenage schoolchildren 13 to 19 years of age in São Gonçalo, Rio de Janeiro State. Depression was assessed with the Childhood Depression Inventory, and adverse childhood experiences were investigated. The study used bivariate analyses and multiple correspondence analysis (MCA) of adverse childhood experiences, sociodemographic variables (sex, skin color, socioeconomic status), and depressive symptoms. The results reveal the organization of eight groups: lower-income female children and adolescents and adverse childhood experiences related to the environment; boys, with higher socioeconomic status, and not having experienced adverse childhood experiences; adolescents with depressive symptoms and adverse childhood experiences against themselves or their families; white adolescents, with depressive symptoms, and that had not experienced adverse childhood experiences; black, brown, Asian-descendant, and indigenous adolescents that had adverse experiences in the family and community; adolescents that had lost their father and/or mother from death, and lack of food at home; adolescents that had experienced psychological violence; and adolescents with a history of sexual experiences involving their parents. The findings call attention to the need for close and early attention to exposure to adverse childhood experiences to care for these youngsters, intervene, and mitigate the negative effects both at present, over the course of life, and in future generations.

Developmental Trajectory of Depressive Symptoms in Chinese College Students: Latent Classes and Gender Effect

Depressive symptoms are prevalent in Chinese college students, but little is known about the heterogeneity in the developmental trajectory of depressive symptoms in China. This study examined heterogeneity in the development of depressive symptoms and examined the effect of gender on the developmental trajectories over a 14-month period among Chinese college students (N = 1163, mean age 20.18, 80.31% female). Three different trajectories, moderate-increasing, high-stable and low-stable, captured the heterogeneity in the development of depressive symptoms. Gender showed significant influence on class membership. Relative to the moderate-increasing class, males emerged as significantly more likely than females to be found in the low-stable class (odds ratio (OR) = 2.73, 95% CI = (1.21, 6.13), p = 0.015) and the high-stable class (OR = 5.10, 95% CI = (1.12, 23.18), p = 0.035). The results provide additional evidence for the conclusion that the trajectories of depressive symptoms are heterogeneous with Chinese samples. Moreover, cultural difference should be paid more attention to when examining the effect of gender and other predictors of the trajectories of depressive symptoms.

Psychopathological symptoms as precursors of depressive symptoms in adolescence: a prospective analysis of the GINIplus and LISA birth cohort studies

INTRODUCTION

Depressive symptoms are highly prevalent in adolescence, highlighting the need for early identification of precursors. Research into psychopathological symptoms predicting depressive psychopathology in adolescents is therefore of great relevance. Moreover, given that the prevalence of depressive symptomatology in adolescence shows marked differences between girls and boys, insight into potential sex-specific differences in precursors is important.

METHODS

This study examined the relationships between emotional problems, conduct problems, hyperactivity/inattention, peer problems, and difficulties in prosocial behaviour at age 10 (Strengths and Difficulties Questionnaire), and the presence of depressive symptoms at age 15 (Depression Screener for Teenagers). Using data from 2824 participants of the GINIplus and LISA birth cohorts, the association of each SDQ subscale at age 10 years with the presence of depressive symptoms at age 15 years was analyzed using sex-specific logistic regression, adjusting for potential confounders.

RESULTS

Emotional problems [odds ratio (OR) 1.99, p = 0.002 for boys and OR 1.77, p < 0.001 for girls] and peer problems (OR 2.62, p < 0.001 for boys, OR 1.91, p = 0.001 for girls) at age 10 showed an increased risk for the presence of depressive symptoms at age 15. Additionally, boys with conduct problems at age 10 were at greater risk of showing depressive symptoms in adolescence (OR 2.50, p < 0.001).

DISCUSSION

Based on the identified prospective relationships in our study, it might be of particular importance to tailor prevention approaches during childhood to peer and emotional problems to reduce the risk of depressive psychopathology in adolescence. Moreover, particularly in boys, it seems important to also target conduct problems in childhood as a precursor of depressive symptoms in the adolescent period.

Early identification of depressive symptoms in school-aged children: Psychometric properties and validation of a new short version of Short Mood & Feelings Questionnaire

BACKGROUND

Depressive mood is a common problem among children in Western countries. Professionals in school and other health services have an important role in identifying children at increased risk for depression. The Short Mood and Feelings Questionnaire (SMFQ) is a widely used screening tool, but its 13 items still make it quite time-consuming to complete. There is an urgent need for a quick and easy-to-complete self-report depressive mood scale for use in school health examinations.

AIM

This paper aims to describe and validate a revised version of SMFQ: FsMFQ-6 is intended as a short screening tool for the early identification of depressive symptoms in children.

METHODS

Nationally representative data (n = 95,725) were drawn from the 2017 School Health Promotion Study. The respondents were fourth- and fifth-grade pupils (aged 10-12) in Finnish primary schools. The data were analysed separately by gender. The construct validity of the scale was studied by principal component analysis and confirmatory factor analysis (CFA), convergent validity by both receiver operating characteristic (ROC) analysis and Spearman's correlation coefficient. Reliability was tested by Cronbach's alpha coefficient.

RESULTS

Principal component analysis yielded a one-component model: the Finnish Short Mood and Feelings Questionnaire 6 (FsMFQ-6). CFA confirmed the validity of FsMFQ-6. Compared with mood at home (AUC = 0.80) and mood at school (AUC = 0.85), overall sensitivity and specificity were optimal at cut-off point 0. Cronbach's alpha coefficient was 0.73, indicating good internal consistency. The results for girls and boys were almost identical.

CONCLUSION

The results confirmed the validity and reliability of FsMFQ-6. FsMFQ-6 recognises depressive mood in children and is suitable for screening depressive symptoms in fourth- and fifth-grade pupils in Finland. However, it is important to pay close attention to children who choose the 'Sometimes' response option more than once, for that can be a sign of depressive symptoms.

Early life mental health and problematic drinking in mid-adulthood: evidence from two British birth cohorts

PURPOSE

Accumulating evidence suggests that externalising problems are consistently associated with alcohol use behaviours, but findings are inconsistent regarding the role of internalising problems. We investigate whether externalising and internalising problems are associated with problematic drinking in mid-adulthood, and whether potential associations are modified by age, sex and cohort.

METHODS

The National Child Development Study (NCDS58, n = 17,633) and 1970 British Cohort Study (BCS70, n = 17,568) recruited new-borns in Great Britain in a single week in 1958 and 1970. Mental health was assessed with the Rutter Behaviour Questionnaire at ages 7, 11, and 16 in NCDS58 and ages 5, 10 and 16 in BCS70. Problematic drinking was measured with the CAGE questionnaire at age 33 in NCDS58 and age 34 in BCS70, and the AUDIT scale at age 44/45 in NCDS58 and age 46 in BCS70. Latent scores of externalising and internalising problems were added chronologically into lagged logistic regression models.

RESULTS

Externalising and internalising problems were associated in opposite directions with problematic drinking in mid-adulthood. Externalising was a risk factor (OR [95% CI] ranging from 1.06 [1.03, 1.10] to 1.11 [1.07, 1.15] for different ages), and internalising was a protective factor (OR [95% CI] ranging from 0.95 [0.92, 0.99] to 0.90 [0.86, 0.94] for different ages). Associations between early life mental health and mid-adulthood problematic drinking did not differ by developmental timing but were stronger in males.

CONCLUSION

Our study provides new insights on links of externalising and internalising difficulties with alcohol use and has implications for public policy in the UK.

Maternal and paternal depression and child mental health trajectories: evidence from the Avon Longitudinal Study of Parents and Children

BACKGROUND

The relationships between offspring depression profiles across adolescence and different timings of parental depression during the perinatal period remain unknown.

AIMS

To explore different timings of maternal and paternal perinatal depression in relation to patterns of change in offspring depressive mood over a 14 year period.

METHOD

Data were obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC). Parental antenatal depression (ANTD) was assessed at 18 weeks gestation, and postnatal depression (PNTD) at 8 weeks postpartum. Population-averaged trajectories of offspring depressive symptoms were estimated using the Short Mood and Feelings Questionnaire (SMFQ) on nine occasions between 10 and 24 years of age.

RESULTS

Full data were available for 5029 individuals. Offspring exposed to both timings of maternal depression had higher depressive symptoms across adolescence compared with offspring not exposed to ANTD or PNTD, characterised by higher depressive symptoms at age 16 (7.07 SMFQ points (95% CI = 6.19, 7.95; P < 0.001)) and a greater rate of linear change (0.698 SMFQ points (95% CI = 0.47, 0.93; P = 0.002)). Isolated maternal ANTD and to a lesser extent PNTD were also both associated with higher depressive symptoms at age 16, yet isolated maternal PNTD showed greater evidence for an increased rate of linear change across adolescence. A similar pattern was observed for paternal ANTD and PNTD, although effect sizes were attenuated.

CONCLUSIONS

This study adds to the literature demonstrating that exposure to two timings of maternal depression (ANTD and PNTD) is strongly associated with greater offspring trajectories of depressive symptoms.

Adolescent antecedents of maternal and paternal perinatal depression: a 36-year prospective cohort

BACKGROUND

Rates of common mental health problems (depression/anxiety) rise sharply in adolescence and peak in young adulthood, often coinciding with the transition to parenthood. Little is known regarding the persistence of common mental health problems from adolescence to the perinatal period in both mothers and fathers.

METHODS

A total of 393 mothers (686 pregnancies) and 257 fathers (357 pregnancies) from the intergenerational Australian Temperament Project Generation 3 Study completed self-report assessments of depression and anxiety in adolescence (ages 13-14, 15-16, 17-18 years) and young adulthood (ages 19-20, 23-24, 27-28 years). The Edinburgh Postnatal Depression Scale was used to assess depressive symptoms at 32 weeks pregnancy and 12 months postpartum in mothers, and at 12 months postpartum in fathers.

RESULTS

Most pregnancies (81%) in which mothers reported perinatal depression were preceded by a history of mental health problems in adolescence or young adulthood. Similarly, most pregnancies (83%) in which fathers reported postnatal depression were preceded by a preconception history of mental health problems. After adjustment for potential confounders, the odds of self-reporting perinatal depression in both women and men were consistently higher in those with a history of persistent mental health problems across adolescence and young adulthood than those without (OR_women 5.7, 95% CI 2.9-10.9; OR_men 5.5, 95% CI 1.03-29.70).

CONCLUSIONS

Perinatal depression, for the majority of parents, is a continuation of mental health problems with onsets well before pregnancy. Strategies to promote good perinatal mental health should start before parenthood and include both men and women.

Risk and resource factors for depressive symptoms during adolescence and emerging adulthood - A 5-year follow-up using population-based data of the BELLA study

INTRODUCTION

Depression is one of the most common mental disorders in adolescents and young adults worldwide, and causes a high burden for both individuals and society. The present study aims to investigate the role of risk and resource factors for depressive symptoms during adolescence and emerging adulthood in a German population-based cohort.

METHODS

Within the longitudinal BELLA study, data on risk and resource factors were collected among n = 632 children and adolescents aged 11 to 17 years. Depressive symptoms were measured five years later. Multivariate linear regression models served to investigate effects of risk and resource factors on depressive symptoms. Regression models were stratified by gender. Moreover, we explored potential interaction effects.

RESULTS

A negative mother-child relationship predicted depressive symptoms in girls, whereas school stress served as a risk factor in boys. Peer competence was associated with fewer depressive symptoms in girls, and family cohesion was identified as a resource factor in boys. In addition, few moderating effects of resource factors on the association between risk factors and depressive symptoms were found.

LIMITATIONS

As the BELLA study is a population-based observational study, we only identified associations between risk and resource factors and no cause-effect relationships.

CONCLUSIONS

Findings provide evidence of gender-specific risk and resource factors for depression. Individuals who are exposed to risk factors must be monitored during the transition into adulthood. Gender-sensitive prevention and early intervention programs are needed.

Consistencies and differences in posttraumatic stress disorder and depression trajectories from the Wenchuan earthquake among children over a 4-year period

BACKGROUND

Posttraumatic stress disorder (PTSD) and depression are the most prevalent mental disorders following disasters, and they often co-occur. The current study investigated trajectories of PTSD and depression among children after exposure to the Wenchuan earthquake and identified factors associated with PTSD or depression trajectories.

METHODS

Three hundred children who were exposed to the Wenchuan earthquake reported PTSD and depression symptoms 4, 16, 29, 40 and 52 months after the disaster, and potential predictors (age, earthquake exposure, prequake trauma and parental relationship) were identified. The PTSD and depression trajectories were identified with latent growth mixture modeling (LGMM), and the predictors were explored with multinomial logistic regression.

RESULTS

Two depression trajectories emerged: resilient (66.2%) and chronic (33.8%). Three PTSD trajectories emerged: resilient (74.9%), recovery (7.5%) and relapsing (17.7%). Overall, 57.3% of the children had low depression and PTSD symptoms over four years. Depression trajectories were significantly predicted by age and parental relationship, while PTSD trajectories were significantly predicted by trauma exposure and prequake trauma experience.

LIMITATIONS

The children's prequake mental health statuses were unknown, and all assessments relied on self-report questionnaires.

CONCLUSION

The postdisaster developmental course of depression was more stable than that of PTSD, and PTSD and depression had different risk factors. Previous studies that focus only on PTSD or depression trajectories may overestimate children's resilient responses. Longer-term postdisaster intervention should pay more attention to depression than to PTSD.

Deficits in Emotion Regulation Partly Mediate the Relation Between Sleep Problems and Depressive Symptoms in Adolescent Inpatients With Depression

Sleep problems are a risk factor for the development of depressive disorders and influence the severity and treatment of depressive symptoms negatively. To enhance treatment for depression in young people, it is important to advance the understanding of the relationship between sleep problems and depressive symptoms. Since deficits in emotion regulation are discussed as possible underlying mechanisms, the present study investigated the mediating effect of maladaptive and adaptive strategies for emotion regulation on the association between sleep problems and depressive symptoms. Emotion regulation strategies, depression and sleep quality were assessed via self-report in a large clinical sample of 602 adolescents (age 13-18 years) who reported clinically relevant symptoms of depression. The questionnaires were assessed at admission for inpatient psychiatric treatment. Correlation and mediation analyses were performed. There was a significant partial mediation effect (β = 0.554, p < 0.001, R ² = 0.527), indicating that sleep problems influenced depressive symptoms via the decreased use of adaptive strategies and the increased use of maladaptive strategies. Additionally, a direct effect of sleep problems on depressive symptoms emerged (β = 0.251, p < 0.001, R ² = 0.364). This cross-sectional study provides first indications that additional treatment modules focusing on sleep and ER skills in prevention and treatment programs for adolescents would be important steps. Longitudinal studies are needed to substantiate these results.

Persistence and remission of depressive symptoms and psycho-social correlates in Chinese early adolescents

BACKGROUND

This study aimed to investigate a one-year course of persistent/remitted depressive symptoms and associated demographic and psychosocial factors that predict persistent/remitted depressive symptoms in Chinese high school students.

METHODS

One thousand five hundred forty-four Grade 7 students provided data for the first wave. Of the initially recruited students, 483 who were classified as depressed (CESD score ≥ 16) at baseline were then tracked and invited to fill in the questionnaire for a second time (Grade 8) after 1 year. Finally, 435 of them were successfully matched.

RESULTS

Two hundred two (46.4%) of the subset categorized as depressed in the first survey (N = 435) remained with depressive symptoms, while 233 (53.6%) recovered from depression 1 year later. Having siblings, a lower level of positive youth development, non-intact family status, and poor family functioning at baseline significantly predicted a higher likelihood of persistent depression, while those with fathers having higher educational qualifications (bachelor's degree or higher) at baseline showed a significantly higher probability of remitting from depression.

CONCLUSIONS

The findings indicated that the prevalence of persistent depressive symptoms was generally high, and promoting aspects of positive youth development and family functioning for adolescents could be promising in preventing or reducing these symptoms.

Aggressive-Depressive Trajectories in Childhood and Their Associations with Drinking Behaviors and Problems in Adolescence and Emerging Adulthood

Research indicates that externalizing and internalizing pathways emanated in childhood are connected to later drinking behaviors; however, no study has investigated the contemporaneous effects of the two pathways using a person-centered approach that categorizes individuals based on their various developmental patterns. This study examined the distinct patterns of concurrent development of aggression and depressive symptoms in childhood and their associations with later drinking behaviors using data from a 15-year Taiwanese cohort since age 8 (N = 2854, 49% females). Group-based multi-trajectory modeling identified four aggressive-depressive trajectory groups: Moderate, Aggressive, Depressive, and Comorbid, which manifested a sequential risk gradient in alcohol use. Comorbid group, characterized by persistently high levels of aggression and depressive symptoms, has the highest levels of alcohol use and drinking problems and the earliest onset of drinking. Aggressive and Depressive groups have higher levels of alcohol use and earlier onset of drinking than Moderate group. These findings imply the importance of monitoring aggression and depressive symptoms simultaneously and continually in childhood to prevent later drinking.

Examining income dynamics and externalizing and internalizing trajectories through a developmental psychopathology lens: A nationally representative study

Prior research has documented elevations in levels of internalizing and externalizing behaviors among children in lower income families in comparison to more advantaged peers. However, most studies focus on behavior problems at a single point in time or within a short developmental period. Associations between income dynamics and developmental trajectories of behavior problems over time are less understood. To address this, the current study uses data from the National Longitudinal Study of Youth (N = 7,476; 50.8% male) to examine how income dynamics (annual income and income volatility) across three distinct developmental periods from early childhood to early adolescence relate to trajectories of externalizing and internalizing problems. Group-based mixture modeling revealed a five-group trajectory model for externalizing behavior and a four-group trajectory model for internalizing behavior. Higher cumulative annual income predicted greater likelihood of belonging to the low-stable group compared to the other, more problematic groups for both externalizing and internalizing trajectories. In addition, income losses predicted higher risk of membership in any group other than the low-stable group for internalizing and externalizing behavior. Developmental period-specific income dynamics, though not as consistent as cumulative dynamics, also predicted trajectory group membership.

The association between early life mental health and alcohol use behaviours in adulthood: A systematic review

This systematic review aims to summarise current evidence on the association between early life mental health and alcohol use behaviours in adulthood. Peer-reviewed publications were located by searching EMBASE, Medline, PsycINFO, and the ISI Web of Science up to 31 October 2018. Prospective longitudinal studies reporting associations between externalising problems (EXT), internalising problems (INT), depression, anxiety before age 18, and alcohol use behaviours (alcohol consumption, heavy/problematic drinking, alcohol use disorder) after age 18 were included. After screening 17259 articles, 36 articles met the inclusion criteria. Information extracted included strength of associations, age when mental health and alcohol use behaviours were measured, sex differences in the association, and other sample characteristics. 103 tests in 23 articles were identified on the externalising domain and 135 tests in 26 articles on the internalising domain. 37 out of 103 tests reported positive associations between EXT and alcohol use behaviours. The likelihood of observing positive associations was higher for more severe alcohol use outcomes, but this trend disappeared among high-quality studies. Findings on associations between internalising domain and alcohol use varied across their subtypes. INT tended to be negatively associated with alcohol consumption but positively associated with more severe outcomes (heavy/problematic drinking, alcohol use disorder). Depression tended to be positively associated with alcohol outcomes, while no clear association between anxiety and alcohol outcomes was evident. Variation of the association across developmental timing, sex, culture, historical period was explored where appropriate. Great heterogeneity in the current literature calls for greater attention to view the relationship developmentally.

Psychosocial stressors and protective factors for major depression in youth: evidence from a case-control study

BACKGROUND

Severe adverse life events, such as traumatic experiences, are well-known stressors implicated in (youth) major depression (MD). However, to date, far less is known about the role of more common psychosocial stressors in the context of MD, which are part of everyday life during youth. In addition, it is not well-understood whether and how distinct stressors interact with protective factors in youths diagnosed with MD. Thus, the present study aimed at examining several specific psychosocial stressors implicated in a first-episode juvenile MD and addressed the question whether protective factors might moderate the relationship between stressors and a diagnosis of MD.

METHODS

One-hundred male and female youths with MD and 101 typically developing (TD) controls (10-18 years) were included. A large number of qualitatively different psychosocial stressors occurring in various areas of life were assessed via self-report. Moreover, we also investigated sociodemographic and pre- and postnatal stressors, as well as the presence of familial affective disorders via parental-report. Social support and a positive family climate were conceptualized as protective factors and were assessed via self-report.

RESULTS

Results showed that the proportion of youths experiencing specific psychosocial stressors was higher in the MD than in the TD group. In particular, the proportion of youths indicating changes at home or at school, experiences of violence, delinquent behavior, as well as the proportion of youths who were exposed to sociodemographic stressors was higher in the MD than in the TD group. Moreover, the percentage of youths with a family history of an affective disorder, or whose mothers experienced psychological burdens during/after pregnancy was elevated in the MD group. Youths with MD experienced less social support and a less positive family climate than their TD peers. These factors, however, did not buffer the influence of specific stressors on MD.

CONCLUSION

We could show that next to more severe adverse life events, more common psychosocial stressors are linked to youth MD. Importantly, by identifying distinct stressors in youth MD, our results can increase treatment and prevention efforts aiming to improve the outcomes in youths affected by MD or in at-risk individuals.

Factor Structure and Measurement Invariance Across Gender of the Beck Depression Inventory-II in Adolescent Psychiatric Patients

The revised version of the Beck Depression Inventory (BDI-II) is one of the most frequently applied questionnaires not only in adults, but also in adolescents. To date, attempts to identify a replicable factor structure of the BDI-II have mainly been undertaken in adult populations. Moreover, most of the studies which included minors and were split by gender lacked confirmatory factor analyses and were generally conducted in healthy adolescents. The present study therefore aimed to determine the goodness of fit of various factor models proposed in the literature in an adolescent clinical sample, to evaluate alternative solutions for the factor structure and to explore potential gender differences in factor loadings. The focus was on testing bifactor models and subsequently on calculating bifactor statistical indices to help clarify whether a uni- or a multidimensional construct is more appropriate, and on testing the best-fitting factor model for measurement invariance according to gender. The sample comprised 835 adolescent girls and boys aged 13-18 years in out- and inpatient setting. Several factor models proposed in the literature provided a good fit when applied to the adolescent clinical sample, and differences in goodness of fit were small. Exploratory factor analyses were used to develop and test a bifactor model that consisted of a general factor and two specific factors, termed cognitive and somatic. The bifactor model confirmed the existence of a strong general factor on which all items load, and the bifactor statistical indices suggest that the BDI-II should be seen as a unidimensional scale. Concerning measurement invariance across gender, there were differences in loadings on item 21 (Loss of interest in sex) on the general factor and on items 1 (Sadness), 4 (Loss of pleasure), and 9 (Suicidal Thoughts) on the specific factors. Thus, partial measurement invariance can be assumed and differences are negligible. It can be concluded that the total score of the BDI-II can be used to measure depression severity in adolescent clinical samples.

Altered serum interleukin-7 and interleukin-10 are associated with drug-free major depressive disorder

BACKGROUND

Abnormal expression of inflammatory cytokines in major depressive disorder (MDD) suggests the activation of an inflammatory process. The pattern of alterations in cytokine levels is still ambiguous. The present study aimed to evaluate interleukin-7 (IL-7) and interleukin-10 (IL-10) for their involvement in the pathophysiology of MDD and determine their relationships with depression risk.

METHODS

The study included 166 medication-free subjects: 84 MDD patients and 82 sex- and age-matched healthy controls (HCs). A qualified psychiatrist diagnosed patients and evaluated controls based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Hamilton depression rating scale (Ham-D) was used to measure the severity of depression in MDD patients. Serum IL-7 and IL-10 levels were measured using enzyme-linked immunosorbent assay (ELISA) kits.

RESULTS

Compared with HCs, the serum levels of IL-7 were significantly decreased, whereas that of IL-10 increased in MDD patients. Moreover, the severity of depression is correlated with the altered levels of IL-7 and IL-10 in MDD patients. We found a negative correlation between IL-7 and Hamilton depression rating (Ham-D) scores (r = -0.580, p < 0.05), whereas there was a positive correlation between IL-10 and Ham-D scores (r = 0.555, p < 0.05).

CONCLUSIONS

The altered levels of serum IL-7 and IL-10 in MDD patients may represent a homeostatic mechanism that enhances the inflammatory process during depression. The alterations of these cytokine levels in MDD and their association with the severity of depression support them as promising, but there may still be controversial factors for understanding the pathophysiology of depression.

Using administrative data to examine variables affecting the mental health of siblings of children who have a developmental disability

BACKGROUND

There is evidence that siblings of children with a developmental disability (DD) experience poorer mental health outcomes and increased stress compared to siblings of non-disabled children. The variables which contribute to this are unclear.

AIMS

This study was designed to examine population-level and individual variables associated with differences in mental health outcomes among siblings of children who have a variety of developmental disabilities.

METHODS

Population-level administrative health data covering 1985-2014 for the province of British Columbia, Canada were used to develop a cohort of over 45,000 children who have a sibling with a DD. Individual-level, demographic and health care services variables were used in logistic regression to assess their relationship to diagnoses of depression or other mental health problems.

OUTCOMES

Odds of a diagnosis of depression or a mental health problem other than depression were associated with sex of the non-disabled sibling, sex of the child with the developmental disability, type of disability, birth order and income.

CONCLUSIONS

Type of developmental disability, and characteristics of the non-disabled sibling and their family are associated with mental health outcomes of siblings of children with a DD.

Girls' internalizing symptoms and white matter tracts in Cortico-Limbic circuitry

Dysfunction in cortico-limbic circuitry is implicated in internalizing disorders (i.e., depressive and anxious disorders), but less is known about whether structural variations precede frank disorder and thus potentially mark risk. We therefore examined associations between white matter (WM) tract microstructure in cortico-limbic circuitry at age 7 and concurrent and longitudinal patterns of internalizing symptoms in 42 typically developing girls using Diffusion Tensor Imaging (DTI). Girls' internalizing symptoms were concurrently associated with reduced fractional anisotropy (FA) in segments of the cingulum bundle (CB) and the uncinate fasciculus (UF), bilaterally. Moreover, latent profile analysis showed that girls with increasing internalizing symptoms, based on assessments at ages 3, 6, 7, and 8, had reduced FA in these segments compared to girls with stably low symptoms. These results point to a putative neural mechanism underlying the course of childhood internalizing symptoms.

Changes in Depression and Positive Mental Health Among Youth in a Healthy Relationships Program

Mental health promotion programming in schools and community settings is an important part of a comprehensive mental health strategy. The goal of this study was to identify and explore meaningful classes of youth based on their pre- and post-intervention depression symptoms scores with 722 youth involved in a 15-week healthy relationships and mental health promotion program. We utilized latent class growth analysis to identify depression class trajectories, controlling for group clustering effects. A three-class solution identified high decreasing, moderate stable, and low stable trajectories. Gender, age, and reported experience of bullying victimization predicted trajectory class membership. The low stable class trajectory was associated with the highest positive mental health, followed by the moderate stable and the high decreasing trajectories. These results suggest that youth with the highest depression scores showed significant improvement in symptomatology over the course of the program.

Review: Longitudinal trajectories of child and adolescent depressive symptoms and their predictors - a systematic review and meta-analysis

BACKGROUND

With depression predicted to contribute to an increased disease burden in coming decades, prevention efforts have become increasingly important. In order to prevent depression it is valuable to identify and classify longitudinal patterns of depressive symptoms across development, ideally beginning early in childhood. To achieve this, longitudinal studies are increasingly using person-centered data-analytic methods to model subgroups with similar developmental patterns (trajectories) of depressive symptoms.

METHOD

A search was completed for English language studies that longitudinally modeled depressive symptom trajectories in nonclinical populations with a baseline age of <19 years. Study characteristics were extracted, prevalence rates and risk factors were summarized, a random-effect meta-analysis was undertaken, and risk of bias analysis completed.

RESULTS

Twenty studies published between 2002 and 2015 were included. Participants were recruited at ages 4 through 17 (average age 12.34) and followed longitudinally for an average of 7.45 years. Between 3 and 11 trajectory subgroups were identified. A random pooled effect estimate identified 56% [95% Confidence Interval (CI) 46-65%] of the sampled study populations (N = 41,236) on 'No or low' depressive symptom trajectories and 26% (CI 14-40%) on a 'Moderate' trajectory. 'High', 'Increasing', and 'Decreasing' depressive symptom subgroups were evident for 12% (CI 8-17%). Moderate symptoms were associated with poorer adjustment and outcomes relative to low symptom groups. 'High' or 'Increasing' trajectories were predominantly predicted by: female gender, low socioeconomic status, higher stress reactivity; conduct issues; substance misuse, and problems in peer and parental relationships.

CONCLUSIONS

The review highlighted consistent evidence of subgroups of children and adolescents who differ in their depressive symptom development over time. The findings suggest preventative interventions should evaluate the longer term benefits of increasing membership in low and moderate trajectories, while also targeting reductions in high-risk subgroups. Considerable between-study method and measurement variation indicate the need for future trajectory studies to use standardized methods.

Factors associated with the emotional health of children: high family income as a protective factor

Anxiety and depressive symptoms have adverse effects on children's development. The present study investigates the associations of socioeconomic factors as well as maternal emotional health with children's emotional health status. The data were collected between 2011 and 2015 in the LIFE Child study, a population-based cohort study in Leipzig, Germany. The emotional health status of 1093 children (2.5-11.9 years old) was investigated using the subscale 'emotional problems' of the Strengths and Difficulties Questionnaire. Associations of maternal emotional health, family status, and socioeconomic status (SES) with the emotional health status of children were estimated via regression analyses. 21.13% of the participating children were assigned to the 'risk' group for emotional problems. The results furthermore revealed that children of mothers reporting more depressive symptoms, children living in single-parent families, and children of families with lower SES scored higher in the emotional problems scale. When considering the different indicators of SES (parental education, occupational status, and monthly net income) separately, only income showed significant associations with children's emotional health status. The prevalence of emotional problems in children in Leipzig, a city in East Germany, appears to be higher than the previously reported German average. Maternal depressive symptoms, single-parent families, lower SES, and especially lower income can be seen as risk factors for children's emotional health.

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.

Stressful life events during adolescence and risk for externalizing and internalizing psychopathology: a meta-analysis

The main objective of the present research was to analyze the relations between stressful life events and the externalizing and internalizing spectra of psychopathology using meta-analytical procedures. After removing the duplicates, a total of 373 papers were found in a literature search using several bibliographic databases, such as the PsycINFO, Medline, Scopus, and Web of Science. Twenty-seven studies were selected for the meta-analytical analysis after applying different inclusion and exclusion criteria in different phases. The statistical procedure was performed using a random/mixed-effects model based on the correlations found in the studies. Significant positive correlations were found in cross-sectional and longitudinal studies. A transactional effect was then found in the present study. Stressful life events could be a cause, but also a consequence, of psychopathological spectra. The level of controllability of the life events did not affect the results. Special attention should be given to the usage of stressful life events in gene-environment interaction and correlation studies, and also for clinical purposes.

Longitudinal Trajectories of Depression Symptoms in Adolescence: Psychosocial Risk Factors and Outcomes

Variations in symptom trajectories within a population may represent distinct groups with different etiologies and outcomes. This study aimed to identify subgroups of depression symptom trajectories in a sample of adolescents, and to describe psychosocial attributes of the different groups. In a longitudinal study, 243 adolescents (121 males and 122 females), were assessed using a battery of measures of temperament, psychopathology, and psychological and behavioral functioning. Four phases of data collection over 7 years spanned average ages of the participants from 12 to 18 years old. Depressive symptoms from each phase were used to model latent class growth trajectories. A 4-group solution was selected as the best-fitting model: (1) ongoing stable low levels of depression; (2) very high depressive symptoms initially, but a steep decrease in symptoms over time; (3) moderately high depressive symptoms initially, but symptoms decreased over time; and (4) initially low levels of symptoms that increased over time. Trajectory group membership was associated with a range of psychosocial variables including temperament, childhood maltreatment, and young adult quality of life. Characterising these subgroups allows for a better understanding of how the interaction of risk factors increases the likelihood of depression and other poor outcomes, and highlights the importance of early interventions to prevent and treat adolescent depression.

Profiles of children's social-emotional health at school entry and associated income, gender and language inequalities: a cross-sectional population-based study in British Columbia, Canada

OBJECTIVES

Early identification of distinct patterns of child social-emotional strengths and vulnerabilities has the potential to improve our understanding of child mental health and well-being; however, few studies have explored natural groupings of indicators of child vulnerability and strengths at a population level. The purpose of this study was to examine heterogeneity in the patterns of young children's social and emotional health and investigate the extent to which sociodemographic characteristics were associated.

DESIGN

Cross-sectional study based on a population-level cohort.

SETTING

All kindergarten children attending public schools between 2004 and 2007 in British Columbia (BC), Canada.

PARTICIPANTS

35 818 kindergarten children (age of 5 years) with available linked data from the Early Development Instrument (EDI), BC Ministry of Health and BC Ministry of Education.

OUTCOME MEASURE

We used latent profile analysis (LPA) to identify distinct profiles of social-emotional health according to children's mean scores across eight social-emotional subscales on the EDI, a teacher-rated measure of children's early development. Subscales measured children's overall social competence, responsibility and respect, approaches to learning, readiness to explore, prosocial behaviour, anxiety, aggression and hyperactivity.

RESULTS

Six social-emotional profiles were identified: (1) overall high social-emotional functioning, (2) inhibited-adaptive (3) uninhibited-adaptive, (4) inhibited-disengaged, (5) uninhibited-aggressive/hyperactive and (6) overall low social-emotional functioning. Boys, children with English as a second language (ESL) status and children with lower household income had higher odds of membership to the lower social-emotional functioning groups; however, this association was less negative among boys with ESL status.

CONCLUSIONS

Over 40% of children exhibited some vulnerability in early social-emotional health, and profiles were associated with sociodemographic factors. Approximately 9% of children exhibited multiple co-occurring vulnerabilities. This study adds to our understanding of population-level distributions of children's early social-emotional health and identifies profiles of strengths and vulnerabilities that can inform future intervention efforts.

Evaluation of a school-based depression prevention program among adolescents with elevated depressive symptoms: study protocol of a randomized controlled trial

BACKGROUND

Adolescents are at risk of developing depressive symptoms. Given the prevalence, recurrence and negative consequences of adolescent depression, it is crucial to implement prevention programs for high-risk adolescents. Prevention programs at an indicated level have shown to be successful in reducing depressive symptoms in adolescents. This study will evaluate the (cost)effectiveness of the prevention program 'Op Volle Kracht (OVK 2.0)' for adolescents with elevated depressive symptoms.

METHODS

We will perform a Randomized Controlled Trial (RCT) with an intervention and control condition to test the effectiveness of an indicated prevention program aimed at depression in adolescents. Adolescents in their second year of secondary education (11-15 year) will be screened for depressive symptoms. Those with heightened levels of depressive symptoms (CDI-2 ≥ 14) will be randomly assigned to the intervention (N = 80) or control group (N = 80). The participants in the intervention condition will receive a prevention program comprising eight meetings of 60 min each. The participants in the control condition will receive psycho-educational information. All participants and their parents will complete assessment at baseline, post-intervention, and 6-, 12- and 24- month follow-up. Primary outcome will be depressive symptoms. Additionally, the present study will identify mechanisms that mediate and moderate the program effects and test the effect of OVK 2.0 on secondary outcomes.

DISCUSSION

This paper describes a study designed to screen adolescents for depressive symptoms and offer them a prevention program to prevent the onset of depressive symptomatology. Adolescents in the intervention condition are expected to show lower levels of depressive symptoms at 12 month follow-up compared to adolescents in the control condition. If OVK 2.0 proves to be effective, the screening and intervention program could be implemented in schools on a large scale.

TRIAL REGISTRATION

Dutch Trial Register NTR5725 . Date registered: 11^th of March 2016.

Latent class profiles of depressive symptoms from early to middle childhood: predictors, outcomes, and gender effects

BACKGROUND

There has been little available data to inform the predictors and outcomes of latent class trajectories of depressive symptoms beginning during preschool and continuing throughout school age. Further, the extant literature in this domain has been limited by the use of parent report checklists of nonspecific 'internalizing' psychopathology rather than diagnostic interviews for depression.

METHODS

To address these gaps in the literature, this study applied growth mixture modeling to depressive symptom severity endorsed by children and/or their caregivers (N = 348) during a structured clinical interview in a 10-year longitudinal dataset spanning from preschool into late school age.

RESULTS

Three distinct trajectories of depressive symptom severity were found in boys and girls. For boys, but not girls, the high depression severity latent class increased in depressive symptoms from preschool through school age, followed by a decline in depressive symptom severity during later school age. For girls, the high depression severity latent class remained stable across time. Early childhood social adversity, familial history of affective disorder, preschool-onset ODD/CD, and school age functional impairment differentiated high-risk trajectory classes among both boys and girls.

CONCLUSIONS

Extending the literature on trajectories of depressive symptoms to the preschool period, these findings incorporate structured clinical interviews of depressive symptom severity and indicate gender differences as well as psychosocial predictors and functional outcomes among children in high severity latent classes. The findings from this study suggest that increased attention to screening for depressive symptoms in early childhood is of significant public health importance.

Developmental trajectories of paediatric headache - sex-specific analyses and predictors

BACKGROUND

Headache is the most common pain disorder in children and adolescents and is associated with diverse dysfunctions and psychological symptoms. Several studies evidenced sex-specific differences in headache frequency. Until now no study exists that examined sex-specific patterns of change in paediatric headache across time and included pain-related somatic and (socio-)psychological predictors.

METHOD

Latent Class Growth Analysis (LCGA) was used in order to identify different trajectory classes of headache across four annual time points in a population-based sample (n = 3 227; mean age 11.34 years; 51.2 % girls). In multinomial logistic regression analyses the influence of several predictors on the class membership was examined.

RESULTS

For girls, a four-class model was identified as the best fitting model. While the majority of girls reported no (30.5 %) or moderate headache frequencies (32.5 %) across time, one class with a high level of headache days (20.8 %) and a class with an increasing headache frequency across time (16.2 %) were identified. For boys a two class model with a 'no headache class' (48.6 %) and 'moderate headache class' (51.4 %) showed the best model fit. Regarding logistic regression analyses, migraine and parental headache proved to be stable predictors across sexes. Depression/anxiety was a significant predictor for all pain classes in girls. Life events, dysfunctional stress coping and school burden were also able to differentiate at least between some classes in both sexes.

CONCLUSIONS

The identified trajectories reflect sex-specific differences in paediatric headache, as seen in the number and type of classes extracted. The documented risk factors can deliver ideas for preventive actions and considerations for treatment programmes.

Moderators of the effects of indicated group and bibliotherapy cognitive behavioral depression prevention programs on adolescents' depressive symptoms and depressive disorder onset

We investigated factors hypothesized to moderate the effects of cognitive behavioral group-based (CB group) and bibliotherapy depression prevention programs. Using data from two trials (N = 631) wherein adolescents (M age = 15.5, 62% female, 61% Caucasian) with depressive symptoms were randomized into CB group, CB bibliotherapy, or an educational brochure control condition, we evaluated the moderating effects of individual, demographic, and environmental factors on depressive symptom reductions and major depressive disorder (MDD) onset over 2-year follow-up. CB group and bibliotherapy participants had lower depressive symptoms than controls at posttest but these effects did not persist. No MDD prevention effects were present in the merged data. Relative to controls, elevated depressive symptoms and motivation to reduce depression amplified posttest depressive symptom reduction for CB group, and elevated baseline symptoms amplified posttest symptom reduction effects of CB bibliotherapy. Conversely, elevated substance use mitigated the effectiveness of CB group relative to controls on MDD onset over follow-up. Findings suggest that both CB prevention programs are more beneficial for youth with at least moderate depressive symptoms, and that CB group is more effective for youth motivated to reduce their symptoms. Results also imply that substance use reduces the effectiveness of CB group-based depression prevention.

Trajectories of Depressive Symptoms in Canadian Emerging Adults

OBJECTIVES

We identified courses of depressive symptoms in an epidemiological sample of emerging adults.

METHODS

We used latent class growth modeling to identify trajectories of depressive symptoms measured by the 12-item Center for Epidemiological Studies Depression Scale (CES-D) during a 14-year follow-up of 2825 Canadian youths aged 10 to 25 years enrolled in the National Longitudinal Survey of Children and Youth between 1994 and 2009.

RESULTS

After adjustment for youth, parent, and family factors, the 3 distinct trajectories of depressive symptoms were minimal (55%; CES-D < 6), subclinical (39%; CES-D = 9-13), and clinical (6%; CES-D > 18). All trajectories exhibited a parallel course, with peak symptoms at 15 to 17 years of age. Subclinical and clinical symptoms were more common than minimal symptoms in female youths and in respondents with lower self-concept, lower socioeconomic status, poorer interpersonal relations, and chronic health conditions (P < .01).

CONCLUSIONS

Among emerging adults, trajectories of depressive symptoms do not trend upward or downward, and variables associated with identified trajectories demonstrated dose-response effects that agreed with vulnerability-stress theories of depression.