Trajectories of Identity Formation Modes and Their Personality Context in Adolescence

National trends in adolescents' mental health by income level in South Korea, pre- and post-COVID-19, 2006-2022

Despite the significant impact of the COVID-19 pandemic on various factors related to adolescent mental health problems such as stress, sadness, suicidal ideation, and suicide attempts, research on this topic has been insufficient to date. This study is based on the Korean Youth Risk Behavior Web-based Survey from 2006 to 2022. We analyzed the mental health problems of adolescents based on questionnaires with medical interviews, within five income groups and compared them with several risk factors. A total of 1,138,804 participants were included in this study, with a mean age (SD) of 15.01 (0.75) years. Of these, 587,256 were male (51.57%). In 2022, the recent period from the study, the weighted prevalence of stress in highest income group was 40.07% (95% CI, 38.67-41.48), sadness was 28.15% (26.82-29.48), suicidal ideation was 13.92% (12.87-14.97), and suicide attempts was 3.42% (2.90-3.93) while the weighted prevalence of stress in lowest income group was 62.77% (59.42-66.13), sadness was 46.83% (43.32-50.34), suicidal ideation was 31.70% (28.44-34.96), and suicide attempts was 10.45% (8.46-12.45). Lower income groups showed a higher proportion with several risk factors. Overall proportion had decreased until the onset of the pandemic. However, a significant increase has been found during the COVID-19 pandemic. Our study showed an association between household income level and the prevalence of mental illness in adolescents. Furthermore, the COVID-19 pandemic has exacerbated mental illness among adolescents from low household income level, underscoring the necessity for heightened public attention and measures targeted at this demographic.

The influence of adolescents' nutrition knowledge and school food environment on adolescents' dietary behaviors in urban Ethiopia: A qualitative study

Adolescence is a critical period of physical, cognitive, and social development that needs to be supported with healthy diets. Dietary behaviours of adolescents can be shaped by their nutrition-literacy and their interaction with parents and peers as well as their school food environment. Therefore, the present study aimed to assess factors that influence dietary behaviours of adolescents in urban Ethiopia. Sex-disaggregated, focused group discussions (n = 70) were conducted in 36 private and government schools (n = 12/city) among adolescents (n = 432) 15-19 years of age in Addis Ababa, Bahir Dar, and Dire Dawa. Photovoice was applied in a subgroup of participants (n = 216) to gain further insights into adolescents' perception of their school food environment. Key informant interviews were conducted among school principals (n = 36). Adolescents had a relatively good nutrition knowledge and recognised the importance of diverse diets, but misperceptions also existed. They identified fruit and vegetables as healthy foods, but their consumption was deterred by food safety concerns. The adolescents identified foods high in salt, fat, and sugar, including processed/packaged foods as unhealthy, but still consumed them frequently due to their taste, affordability, availability and accessibility in and around schools. Both undernutrition and overweight/obesity were linked to social exclusion and bullying in school. Effective behavioural change communication is required to address common misperceptions. School nutrition programs should integrate water, sanitation and hygiene programs to ensure food safety. Regulations promoting healthy eating while discouraging unhealthy dietary behaviours are vital. Interventions to make nutrient-dense and healthy foods available, accessible, and affordable are urgently needed to improve the nutrition and health outcome of adolescents.

Drivers of uptake of HIV testing services, a snapshot of barriers and facilitators among adolescent boys and young men in Lusaka: a qualitative study

BACKGROUND

Striking gender and rural-urban disparities highlight the need to redesign HIV services to improve HIV testing and linkage by adolescent boys and young men (ABYM) in sub-Saharan African cities.

PURPOSE

We sought to understand drivers of HIV testing among ABYM living in urban Lusaka in order to design a targeted intervention that may increase their entry into the HIV prevention and treatment cascade.

METHODS

In May and June 2019, two male moderators conducted three focus group discussions lasting 1.25 hours with seven to nine ABYM per group and six in-depth interviews with healthcare providers (HCPs) working with adolescents. ABYM were conveniently selected from first aid training, sports and youth-friendly sites in three settlement areas. We purposefully selected HCP from community, facility and district levels. Thematic analyses using inductive reasoning were applied.

RESULTS

The 24 ABYM were 18-24 years old (median 21 years), single, from 11 different neighbourhoods and 79% had 9-12 years of education. Facilitators of HIV testing uptake included the importance ABYM placed on good health and planning their future in order to fulfil their masculine identity and societal roles. Barriers included peer norms, life-long treatment along with anticipated changes to sexual life and alcohol use, fear of results and judgement and disappointment among HCP. HCPs agreed that masculine roles ('many things to do') and arduous clinical processes deterred ABYM from accessing testing services. They suggested that ABYM were prone to depression which both caused and resulted from behavioural issues such as alcohol use and risk-taking, which prevented uptake of HIV testing services. Both parties agreed that ABYM needed services specifically designed for them and that offered convenient, private, swift and non-judgemental services.

CONCLUSIONS

ABYM disillusioned by standard counselling procedures, systemic barriers and stigma, avoid HIV test and treat services. Innovative ways and youth-specific spaces are needed to increase access to non-judgemental services that facilitate entry into the HIV prevention and treatment cascade in this population.

Stability and cross-lagged relations among callous-unemotional traits, moral identity, moral emotion attribution and externalizing behavior problems in adolescents

This study investigates the associations of adolescents callous-unemotional traits with moral constructs and the interplay of various outcomes. The present study builds on the lack of research and focuses on the longitudinal relationships between CU-traits, moral identity, moral emotion attribution and externalizing behavior problems in adolescence. The included variables were collected at test time points T1 and T2. To determine the predictive, and stability links among the variables, a cross-lagged model in SPSS AMOS 26 was conducted. Time stability path estimates were moderate to highly stable over time for all included variables. Significant cross lagged paths of moral identityT1 on moral emotion attributionT2, CU-traitsT1 on moral identityT2, externalizing behavior problemsT1 on moral emotion attributionsT2 and externalizing behavior problemsT1 on CU-traitsT2, could be found.

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.

The use of social media as a two-way mirror for narcissistic adolescents from Austria, Belgium, South-Korea, and Spain

The use of social networking sites (SNS or social media) often comes with strong self-centered behaviors to promote self-appearance. The relationship between narcissism and social media use has intensively occupied scholars in the last decade, yet not much research has focused on, first, how the intensity of social media use (SNS use) is associated with narcissism through a self-centered appearance focused use of these SNS; and second, whether these associations are moderated or not by cultural differences of the country of origin in such a critical age of personality formation and (global) culturalization as the transition from pre-adolescence to adolescence. We performed a correlation and mediation analysis on a cross-sectional survey among Austrian, Belgian, Spanish, and South Korean adolescents (n = 1,983; Mage 14.41, 50.3% boys) examining the adolescents' daily usage of social media, their self-centered appearance focused behavior, and the reported narcissism. Findings show that a self-centered appearance focused use of SNS (SCA) moderates the association between SNS use and narcissism, especially for males from the three European countries. We have also particularly found that the years of use, number of friends and time spent in FB are associated with narcissism. Since SCA is defined in the study as narcissistic behavior in SNS, we argue that social media are part of the socialization process as both reinforcers and catalyzers of narcissism.

The Importance of Identity Style for the Level of Religiosity in Different Developmental Periods

Identity is built in the context of an individual’s professed values, moral principles, and often, religiosity. Adolescence and emerging and early adulthood are times of intensive identity construction and of changes in religious attitudes. Therefore, the aim of this study was to characterise people across these three developmental periods in terms of the level of their identity and religiosity, and to examine whether particular identity styles allow for the prediction of the overall level of religiosity. For this purpose, the whole sample of N = 1017 individuals and particularly from adolescence (n = 307), emerging adulthood (n = 410), and early adulthood (n = 302) were studied. The results showed a lower level of the informational style and a higher level of the diffuse-avoidant style in adolescence as compared with the two older groups, who did not differ from each other. The overall level of religiosity did not significantly differentiate the developmental groups; however, it was explained by identity formation styles in different ways at particular developmental stages. Results of moderation analyses suggest that the informational style has positive effect only in adolescence; the normative style has positive effects in each age group but is strongest in early adulthood, and the diffuse-avoidant style presents negative effect in adolescence.

Social Support and Suicide Risk Among Chinese University Students: A Mental Health Perspective

Background: World Health Organization recognizes suicide as a public health priority. This study aimed to investigate the risk life events which led university students to consider suicide and explore the protective mechanism of social support (including subjective support, objective support, and support utilization) on suicide risk. Methods: Three thousand nine hundred and seventy-two university students were recruited in Harbin, China. Social Support Rating Scale, Self-Rating Anxiety Scale, the Beck Depression Inventory, and the 25-item scale of suicide acceptability were used to collect participants' information. Descriptive statistics, Pearson's correlation, and mediation analysis were employed for statistical analysis. Results: "Drug addict," "infected with HIV," and "incurable illness" were the top three events that led university students to consider suicide. Social support played an important protective role against suicide risk. Subjective support and support utilization had total effects on suicide acceptability, including direct and indirect effects. Anxiety (indirect effect = -0.022, 95% CI = -0.037 ~ -0.009) and depressive symptoms (indirect effect = -0.197, 95% CI = -0.228 ~ -0.163) mediated the relationship between subjective support and suicide acceptability; meanwhile, the association between support utilization and suicide acceptability was mediated by anxiety (indirect effect = -0.054, 95% CI = -0.088 ~ -0.024) and depressive symptoms (indirect effect = -0.486, 95% CI = -0.558 ~ -0.422). However, the protective impact of objective support worked totally through decreasing anxiety (indirect effect = -0.018, 95% CI = -0.035 ~ -0.006) and depressive symptoms (indirect effect = -0.196, 95% CI = -0.246 ~ -0.143). Moreover, the mediation effects of depressive symptoms had stronger power than anxiety in the impact of social support on suicide risk. Conclusions: Among Chinese university students, suicide acceptability was elevated when there was a health scare. Social support effectively reduced suicide risk via decreasing anxiety and depressive symptoms. From the mental health perspective, families, peers, teachers, and communities should work together to establish a better social support system for university students, if necessary, help them to seek professional psychological services.

Searching for Autonomy before the Transition to Higher Education: How do Identity and Self-Determined Academic Motivation Co-Evolve?

Identity and academic motivation are particularly at stake before the major transition to higher education. However, few studies have explored their changes and their longitudinal bidirectional links. To fill this gap, a three-wave study from the end of the 11th grade to the end of the 12th grade was conducted to explore changes in identity processes and academic motivation and to investigate how they might be interconnected over time. 599 adolescents (mean age 17.4; 59% girls) completed questionnaires containing measures about identity processes and three types of academic motivation: autonomous, controlled, and impersonal. Throughout the study span of one year, four identity processes increased: commitment making, identification with commitment, exploration in breadth and exploration in depth, while the process of ruminative exploration decreased. Simultaneously, late adolescents encountered an increase in impersonal motivation, more salient for boys. The results also revealed unidirectional links from motivation to identity processes, with no gender or age moderator effects: exploration in breadth and exploration in depth were positively predicted by autonomous motivation, ruminative exploration was positively predicted by autonomous, controlled, and impersonal motivation. In addition, impersonal motivation negatively predicted commitment making. On the other hand, identification with commitment positively predicted autonomous motivation. Practical implications are discussed.

Change and Consistency of Self-Esteem in Early and Middle Adolescence in the Context of School Transition

Self-esteem is continuous and has stable characteristics, but it may also change, e.g., during transitions from one educational level to the next. In a prospective cross-sectional study over a year and a half, 250 Polish early adolescents (N = 109, 54 girls; mean age at T1 = 12.68 years, SD = 0.49) and middle adolescents (N = 141, 107 girls; mean age at T1 = 15.80, SD = 0.44) were tested three times using Harter’s Self-Perception Profile for Adolescents, assessing both global self-esteem and self-evaluation in eight domains. The change and consistency of self-esteem were analyzed, at both group and individual levels. At the group level, the following results were found: (1) continuity of self-esteem in five domains (scholastic competence, athletic competence, physical appearance, close friendship, and romantic appeal) and in global self-esteem and discontinuity in only three domains (social acceptance, job competence, and behavioral conduct); (2) significant inter-individual variation in the change not explained by age; and (3) higher self-esteem (in five domains) in early adolescents. At the individual level, the stability in most domains was weak, but was restored over the second year at the new school. The complexity of the developmental change and consistency in self-esteem in adolescence was highlighted, emphasizing the need for analyzing both group and individual change.