At-risk depressive symptoms and alcohol use trajectories in adolescence: a person-centred analysis of co-occurrence

The mediating role of impulsivity on suicidal behaviour among higher education students with depression and substance abuse disorders

BACKGROUND

Alcohol and drug dependent individuals have consistently exhibited elevated impulsivity and some studies have indicated that impulsivity recorded in young adults predicts future alcohol abuse. Research also indicates that depressed individuals with higher impulsivity are more likely to report suicidal ideation even when they are less depressed, which may indicate that impulsivity could more strongly predict suicidality than severity of depressive symptoms.

OBJECTIVE

The aim of this study was to investigate the mediating role of impulsivity on suicidal behaviour and self-harm among students with depression, alcohol and substance abuse disorders.

MATERIALS AND METHODS

Participants were first-year undergraduate students (n = 1829) across Ulster University (NI) and Letterkenny Institute of Technology - now known as Atlantic Technological University Donegal (ROI), who were recruited as part of the World Mental Health International College Student Initiative. Participants completed an online survey utilising the WMH-Composite International Diagnostic Interview Screening Scales (CIDI-SC). Mediation analyses were conducted in three different stages.

RESULTS

A high prevalence of depression and substance use disorders, suicidal ideation, plans, attempts and self-harm were observed. Impulsivity was found to partially mediate the association between depression and suicidal behaviours and substance use disorders and suicidal behaviours. Impulsivity was significantly associated with suicide ideation, attempts and self-harm, but not suicide plans. Males were more likely to be impulsive, and higher levels of depression and substance use disorders were related to higher impulsivity.

CONCLUSIONS

The main findings of this study reinforce the role of impulsivity in mediating the relationship between depression and suicidality and substance use and suicidality. College wellbeing services may consider whether screening for impulsivity, rather than for example substance abuse, could be more beneficial and less prone to under-reporting, when assessing for suicide risk among vulnerable students.

The Correlation Between Emotionality Changes and Alcohol Consumption in Young Persons: A Pilot Study

Background/Objectives: Alcohol consumption in young persons is a growing phenomenon, with significant implications for physical and mental health. This behavior exposes adolescents and young adults to multiple risks, such as affecting cognitive functions, the development of emotional disorders, and social integration difficulties. The present study sets out to investigate the way alcohol consumption influences emotionality in young people, focusing on the emotional changes (anxiety and irritability), cognitive changes (attention deficit and memory disorder), and behavioral changes (impulsivity and aggressiveness). Methods: The methodology involved collecting quantitative data from a sample of young people who consume and do not consume alcohol, using standardized questionnaires and advanced statistical software (processed in MATLAB version 9.11_R2021b). We analyzed variables such as consumption frequency and intensity, affective scores, and demographic factors to highlight the correlations between consumption level and the intensity of affective modifications. Results: The results revealed a significant association between alcohol consumption and the rise in anxiety and depression symptoms or a tendency toward impulsive behaviors. Additionally, we observed that psychosocial factors, including group pressure, family climate, and stressful contexts, can exacerbate emotional vulnerability. Conclusions: This study suggests the need for early psychological interventions and prevention programs to approach emotional and cognitive dimensions and the social influences associated with consumption. Implementing support and counseling strategies, as well as education and awareness campaigns, can contribute to reducing risky behavior and promoting young people's harmonious development.

Coupled changes between ruminating thoughts and resting-state brain networks during the transition into adulthood

Perseverative negative thoughts, known as rumination, might arise from emotional challenges and preclude mental health when transitioning into adulthood. Due to its multifaceted nature, rumination can take several ruminative response styles, that diverge in manifestations, severity, and mental health outcomes. Still, prospective ruminative phenotypes remain elusive insofar. Longitudinal study designs are ideal for stratifying ruminative response styles, especially with resting-state functional MRI whose setup naturally elicits people's ruminative traits. Here, we considered self-rated questionnaires on rumination and psychopathology, along with resting-state functional MRI data in 595 individuals assessed at age 18 and 22 from the IMAGEN cohort. We conducted independent component analysis to characterize eight single static resting-state functional networks in each subject and session and furthermore conducted a dynamic analysis, tackling the time variations of functional networks during the entire scanning time. We then investigated their longitudinal mediation role between changes in three ruminative response styles (reflective pondering, brooding, and depressive rumination) and changes in internalizing and co-morbid externalizing symptoms. Four static and two dynamic networks longitudinally differentiated these ruminative styles and showed complemental sensitivity to internalizing and co-morbid externalizing symptoms. Among these networks, the right frontoparietal network covaried with all ruminative styles but did not play any mediation role towards psychopathology. The default mode, the salience, and the limbic networks prospectively stratified these ruminative styles, suggesting that maladaptive ruminative styles are associated with altered corticolimbic function. For static measures, only the salience network played a longitudinal causal role between brooding rumination and internalizing symptoms. Dynamic measures highlighted the default-mode mediation role between the other ruminative styles and co-morbid externalizing symptoms. In conclusion, we identified the ruminative styles' psychometric and neural outcome specificities, supporting their translation into applied research on young adult mental healthcare.

Effects of binge drinking and depression on cognitive-control processes during an emotional Go/No-Go task in emerging adults

INTRODUCTION

The goal of the current study was to examine differences in neurocognitive processes across groups marked by binge drinking and depression to identify patterns of cognitive and affective processing impairments.

METHODS

Undergraduate students (N = 104; 64% female) were recruited based on self-reported symptoms of depression and alcohol use. They completed an emotional Go/No-Go task while undergoing EEG. Mean amplitudes for N2 and P3 components were examined with 2 (Depressed/Non-depressed) X 2 (Binge/Non-binge drinkers) X 4 (Happy/Sad/Angry/Calm) X 3 (Left/Middle/Right) X 2 (Go/No-Go) repeated measures ANOVAs.

RESULTS

There were significant Trial Type X Valence X Depression X Binge Drinking interactions for N2 (F(3, 80) = 6.62, p < .01) and P3 (F(3, 80) = 4.65, p < .01) components. There was a significant Valence X Depression X Binge Drinking interaction for response bias (F(3, 65) = 3.11, p < .05).

LIMITATIONS

The source of our sample may be a limitation, as all participants were university students, potentially making the results less generalizable. Further, we cannot be certain that social desirability did not interfere with honest reporting of alcohol use in this population.

CONCLUSIONS

Differences in early inhibitory control were observed across emotions based on trial type among depressed non-binge drinkers, and these differences were attenuated in the presence of binge drinking. Further, the effects of depression on later inhibitory control were specific to non-binge drinkers. Results help to clarify the nature of underlying patterns of neurocognitive and affective risk processes that could be targeted by prevention and intervention programs.

Correlates of Alcohol Use Likelihood for Latino Immigrant Youth in an Emerging Context

Using a three-wave prospective longitudinal design spanning 3 years, we assessed alcohol use likelihood trajectories and their correlates among a community sample of Latino immigrant adolescents in the emerging immigrant context of Western Oregon. Results from growth mixture modeling revealed two distinct classes: lower risk youth who reported little likelihood of alcohol use but whose trajectory was increasing, and higher risk youth who reported higher likelihood of alcohol use and whose trajectory was stable. We found significant differences between the two classes such that lower risk youth reported greater levels of Latino cultural orientation and parental monitoring, whereas higher risk youth reported greater levels of family cultural stress and delinquency. Results are discussed in terms of prior research and theory.

Trajectories of Substance Use and Well-being in Early and Middle Adolescence Shaped by Social Connectedness

Increasing substance use and decreasing well-being are typical in adolescence, yet how social contexts shape disparate development during this time is less well-understood. A latent growth class analysis was conducted that identified groups of early (N = 706; Age_m  = 12.20) and middle (N = 666; Age_m  = 14.38) adolescents distinguished by rates of substance use and well-being over three years. In both cohorts, the largest group reported low substance use and high well-being, with a smaller group exhibiting maladaptive trajectories for both substance use and well-being. Two additional groups were identified during middle adolescence characterized by either low well-being or high substance use. Family connectedness was a protective factor, while high peer connectedness was a risk factor for substance-use groups and low peer connectedness for languishing.

The role of substance use coping in linking depression and alcohol use from late adolescence through early adulthood

Although theoretical models highlight the role of coping motivations in promoting co-development of depression and alcohol use, few longitudinal studies have examined such processes across early adulthood. The current study examined the role of coping in the association between depression and alcohol use across late adolescence and early adulthood. A control sample of adolescents (N = 498) from a longitudinal prevention trial completed the Brief Symptom Inventory, Life Events Coping Inventory, and a self-report survey on alcohol use at ages 17, 22, and 23, as well as the Composite International Diagnostic Interview at age 28-30. Path analyses integrated self-report and diagnostic measures. Although gender differences were observed in mean levels of depression, alcohol use, and the use of substances to cope, we did not find gender differences in structural relations across these domains over time. Substance use coping served as an intervening pathway in the association between alcohol use and depression both at the symptom level from age 17 to 23, and in predicting longer term diagnostic outcomes at ages 28-30. Depressive symptoms in early adulthood were indirectly related to major depressive disorder (MDD) through two independent paths, including the stability of depressive symptoms over time, and through the influence of depression on increasing the tendency to use substances to cope with stress. Our results underscore that coping effects provide unique predictive power across developmental transitions, over and above the stability of depressive symptoms and alcohol use, underscoring coping motives as a promising intervention target that may prevent co-occurring depression and substance use. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Reciprocal Relationships between Sleep Problems and Problematic Smartphone Use in Taiwan: Cross-Lagged Panel Study

Prior studies have suggested a link between sleep problems and problematic smartphone use. However, the causal relationships between these two variables have not been identified, particularly in adolescence. Utilizing longitudinal panel data from Taiwan, this report examined the temporal relationships between sleep problems and problematic smartphone use among adolescents. One thousand and thirty-nine students (Grades 7-12) were surveyed at two-time points with a 6-month interval. The results of cross-lagged panel analysis showed that sleep problems at Time 1 significantly predicted problematic smartphone use at Time 2. Problematic smartphone use at Time 1 also significantly predicted sleep problems at Time 2. These findings applied to boys and girls and suggested that temporal relationships between sleep problems and problematic smartphone use among teenagers are reciprocal. Accordingly, increasing sleep quality may prevent future problematic smartphone use, while reducing problematic smartphone use may prevent sleep problems in adolescents.

Dual Trajectories of Depression/Anxiety Symptoms and Alcohol Use, and their Implications for Violence Outcomes Among Drug-Using Urban Youth

AIM

To examine dual trajectories of anxiety/depression symptoms and alcohol use among drug-using youth seeking care from an urban emergency department (ED), their baseline correlates and co-occurring trajectories of severe violence.

SHORT SUMMARY

There were five characteristic dual trajectories of alcohol use and depression/anxiety symptoms. Community violence exposure was highest among individuals with high-depression/anxiety symptom trajectories. Individuals with concurrently high-alcohol use and depression/anxiety symptom trajectories reported that the most delinquent peer affiliations, and had the highest rates of severe violence over time.

METHODS

We analyzed data from 599 drug-using (primarily marijuana) youth ages 14-24 (349 assault-injured) recruited from December 2009 to September 2011 into a 24-month longitudinal study at a Level-1 ED in Flint, Michigan. Youth self-reported substance use, depression and anxiety symptoms, peer/parental behaviors, and severe violence involvement at baseline and four biannual follow-up assessments. Bivariate latent trajectory models identified homogeneous groups with similar trajectories on alcohol use and anxiety/depression symptoms; we compared baseline characteristics of each trajectory group and concurrent trajectories of severe violence (victimization and aggression).

RESULTS

Our model identified five trajectory groups: Low drinking/No symptoms (LN; 10.4%; n = 62), No drinking/Moderate symptoms (NM; 15.7%; n = 94), Low drinking/Moderate symptoms (LM; 30.2%; n = 181), Low drinking/High symptoms (LH; 16.4%; n = 98) and High drinking/High symptoms (HH; 27.5%; n = 164). The HH group was characterized by more delinquent peer associations, and rates of community violence were higher among the high symptom groups. The HH group had the highest severe violence perpetration and victimization rates across time points; the LH group had similar violence rates to the LM and NM groups and the LN group had the lowest violence rates across time.

CONCLUSIONS

Among drug-using youth, alcohol use interventions could benefit from a focus on peer influences, and those with a joint focus on violence involvement may be improved via inclusion of content related to mental health and community violence exposure.

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.

Posttraumatic Stress, Coping Flexibility, and Risky Drinking Among Trauma-Exposed Male and Female College Students: The Mediating Effect of Delay of Gratification

BACKGROUND

The co-occurence of posttraumatic stress (PTS) and risky drinking has been demonstrated in diverse populations, including college students. However, the mechanisms underlying this co-occurrence, as well as the protective factors that may reduce risky drinking among trauma-exposed college students have yet to be fully understood in the literature.

OBJECTIVES

The present study builds upon self-regulation theories and previous empirical work to determine whether the effects of PTS and coping flexibility on risky drinking were mediated by delay of gratification among trauma-exposed college students. In addition, the potential moderating effect of gender on these relationships was examined.

METHODS

Participants included 624 trauma-exposed college students (68.4% female) attending a public university in the southeast region of the United States. Data were collected through an online survey. The hypothesized model was examined using a multigroup structural equation modeling approach.

RESULTS

As hypothesized, PTS had a significant, positive indirect effect on risky drinking through delay of gratification; however, the effect of PTS on delay of gratification was stronger for males than for females. Results also indicated that the indirect effect of coping flexibility on risky drinking through delay of gratification was significant and negative for males and females. Conclusions/Importance: The findings of this study suggest that delay of gratification might be an important mechanism underlying the co-occurrence of PTS and risky drinking. In addition, our results highlight the potential benefits of coping flexibility for college students coping with PTS.

Depressive symptom trajectories in late adolescence and early adulthood: A systematic review

OBJECTIVE

In adolescents and young adults, depressive symptoms are highly prevalent and dynamic. For clinicians, it is difficult to determine whether a young person reporting depressive symptoms is at risk of developing ongoing mood difficulties or whether symptoms form part of a transient maturational process. Trajectory analyses of longitudinally assessed symptoms in large cohorts have the potential to untangle clinical heterogeneity by determining subgroups or classes of symptom course and their risk factors, by interrogating the impact of known or suspected risk factors on trajectory slope and intercept and by tracing the interrelation between depressive symptoms and other clinical outcomes over time.

METHOD

We conducted a systematic review of trajectory studies conducted in cohorts including people aged between 15 and 25 years.

RESULTS

We retrieved 47 relevant articles. These studies suggest that young people fall into common mood trajectory classes and that class membership and symptom course are mediated by biological and environmental risk factors. Furthermore, studies provide evidence that high and persistent depressive symptoms are associated with a range of concurrent health and behavioral outcomes.

CONCLUSION

Findings could assist in the formulation of novel concepts of depressive disorders in young people and inform preventive strategies and predictive models for clinical practice.

Associations between alcohol-use and depression symptoms in adolescence: Examining gender differences and pathways over time

Several studies examining alcohol use and depression in youth have focused on documenting prevalence of overlap, or temporal ordering in longitudinal samples. Fewer studies have examined pathways connecting alcohol use and depression over time. This study examined gender differences between depression and alcohol use across adolescence while examining peer and family pathways as possible mediators of effects. Data was collected longitudinally from 593 families from three urban public middle schools in the United States. Participants were recruited in 6th grade and followed through 9th grade. We examined gender differences using a nested model comparison approach. Results indicated the association between depression and alcohol use differs by gender. For males, depression and alcohol use were independent across adolescence, and no significant indirect pathways were observed. For females, bidirectional effects were found between alcohol use and depression, as well as an indirect effect from depression to alcohol use via peer deviance.

The social ties that bind: social anxiety and academic achievement across the university years

Given that engagement and integration in university/college are considered key to successful academic achievement, the identifying features of social anxiety, including fear of negative evaluation and distress and avoidance of new or all social situations, may be particularly disadvantageous in the social and evaluative contexts that are integral to university/college life. Thus, the purpose of this study was to examine the direct effects of social anxiety on academic achievement, as well as investigate an indirect mechanism through which social anxiety might impact on academic achievement, namely, the formation of new social ties in university. The participants were 942 (71.7 % female; M = 19 years at Time 1) students enrolled in a mid-sized university in Southern Ontario, Canada. Students completed annual assessments of social anxiety, social ties, and academic achievement for three consecutive years. The results from an autoregressive cross-lag path analysis indicated that social anxiety had a significant and negative direct relationship with academic achievement. Moreover, the negative indirect effect of social anxiety on academic achievement through social ties was significant, as was the opposing direction of effects (i.e., the indirect effect of academic achievement on social anxiety through social ties). These findings highlight the critical role that social ties appear to play in successful academic outcomes and in alleviating the effects of social anxiety during university/college.