Neurocognitive bases of emotion regulation development in adolescence

Neural dynamics of social anxiety during and after anxiety-provoking and relaxation-inducing: A task and resting-state fMRI study

BACKGROUND

Social anxiety disorder (SAD) is marked by intense fear of social situations and negative evaluation. This study investigated neural effects of SAD-specific imagery scripts and their relationships with Brief Fear of Negative Evaluation (BFNE).

METHODS

Thirty-six SAD and 32 healthy controls underwent four five-minute fMRI runs: anxiety-provoking imagery, rest, relaxing imagery, and rest. The order of imageries was counterbalanced. Functional connectivity analysis and connectome-based predictive modeling with respect to BFNE were performed using six seed regions, including the bilateral amygdala, left hypothalamus, bilateral dorsomedial prefrontal cortex (DMPFC), left ventromedial PFC (VMPFC), and left posterior cingulate cortex (PCC).

RESULTS

Group × task interaction effects were found in connectivity of left amygdala-right cerebellum, left PCC-bilateral superior frontal gyrus, and left PCC-right posterior middle temporal gyrus, and group × engagement effects were discovered in left hypothalamus-bilateral DMPFC and left VMPFC-right DMPFC couplings. Group × task × engagement interactions highlighted aberrant functional connections of right amygdala-left VMPFC, DMPFC-left DLPFC, and left VMPFC-bilateral supplementary motor area in SAD. Patterns of connectivity predicted the BFNE scores in various segments of imagery conditions.

LIMITATIONS

Patient's medication, physiological measures were not considered. Noisy nature of fMRI could have interfered participants from focusing.

CONCLUSIONS

Our results revealed disrupted functional connections associated with emotion dysregulation and overly self-referent thinking in SAD. Markedly, patients showed maladaptive responses related to relaxation-inducing blocks, challenging the expected relaxation response. Overall findings emphasized inappropriate engagements of various processes in relaxing circumstances that do not overtly involve social anxiety to be associated with symptomatology.

Trajectories of the Late Positive Potential Across Childhood and Adolescence: A 9-Year Longitudinal Study

The late positive potential (LPP), an event-related potential reflecting affective processing, may exhibit developmental shifts in magnitude and scalp location. In the present longitudinal study, 501 youth (47.3% female; 89.4% White; 12.0% Hispanic) completed the emotion interrupt task to elicit the LPP to neutral, positive, and negative images at approximately 9, 12, 15, and 18 years old (data collected 2010-2022). Multilevel growth models indicated an initial decrease in the occipital LPP and an increase in the parietal and central LPP during late childhood, with rates of change leveling off across adolescence. Trial condition (i.e., valence) significantly impacted trajectories only when the LPP was measured over occipital sites. Results provide novel evidence of stability and change in the LPP across development.

Agreement between the Amsterdam Neuropsychological Tasks and the Cambridge Neuropsychological Test Automated Battery in theassessment of PKU patients and healthy controls

BACKGROUND

Several neuropsychological testing batteries have been used to assess and monitor neurocognitive functioning in healthy individuals and patients. Two of these test batteries, the Amsterdam Neuropsychological Tasks (ANT) and the Cambridge Neuropsychological Automated Test Battery (CANTAB), have indicated impairments in early- and continuously treated phenylketonuria (PKU) patients. However, the tasks of these batteries have never been cross-validated. This study aims to establish the comparability of the two test batteries in the assessment and monitoring of PKU patients and healthy controls.

METHODS

22 PKU patients and 19 controls of various ages (7-67 years old) were tested twice, once using tasks from the ANT and once using tasks from the CANTAB. Tasks of the two batteries were matched based on the neurocognitive functions they (were deemed to) assess, including motor skills, emotion recognition, sustained attention and executive functions (working memory, inhibitory control, and cognitive flexibility). Correlation matrices were used to assess the specificity of the correlations between tasks assigned to similar skills, versus non-related tasks.

RESULTS

Correlations between matched tasks from the ANT and CANTAB ranged from moderate to strong (range ρ: 0.50-0.84, P < 0.001), with strong correlations (ρ > 0.70) for emotion recognition, cognitive flexibility and sustained attention. These correlations remained significant after correcting for age. The strongest correlations were generally found between tasks assigned to require similar skills a-priori, validating the matching between tasks.

CONCLUSION

Overall, there was a good level of agreement between ANT and CANTAB tasks, especially in emotion recognition, sustained attention and the broad construct of executive functioning. These results suggest that a number of ANT and CANTAB tasks assessing the same functions may be used and interpreted interchangeably, which would support a better integration of neuropsychological research in PKU.

Negative life events during early adolescence are associated with neural deactivation to emotional stimuli

Negative life events (NLEs) have been shown to perturb neurodevelopment and are correlated with poor mental health outcomes in adolescence, the most common period of psychopathology onset. Emotion regulation is a critical component of psychological response to NLEs and interacts, neurobiologically and behaviorally, with working memory. This study leveraged an emotional n-back task to examine how NLEs influence emotion- and working memory-related brain activation using data from 2150 youth in the Adolescent Brain Cognitive Development (ABCD) Study. Greater incidence of NLEs was associated with less activation in the amygdala and more pronounced deactivation in other limbic and frontal brain regions previously implicated in emotion-related cognition; however, this association was present only during emotion processing conditions of the task. While NLEs were not significantly associated with task performance in the final sample, behavioural analyses including youth excluded for low task accuracy and poor neuroimaging data quality showed a significant negative association between NLEs and overall task performance. While behavioural findings across the entire sample support prior work, somewhat incongruent with prior literature, imaging results may suggest that during early adolescence the effects of negative experiences on patterns of neural activation are specific to contexts necessitating emotion processing.

Emotion dynamics prospectively predict depressive symptoms in adolescents: findings from intensive longitudinal data

BACKGROUND

The incidence of depression among adolescents has risen significantly over the past decade. Emotional dynamics, including variability, instability, and inertia of positive affect (PA) and negative affect (NA), are potential risk factors for depressive psychopathology. However, limited longitudinal evidence exists on how these emotion dynamics relate to depression, particularly in collectivistic cultural contexts, where emotional expression and regulation are shaped by social and familial expectations. This study aimed to investigate the longitudinal associations between emotion dynamics-variability, instability, and inertia of PA and NA-and subsequent depressive symptoms among Chinese adolescents.

METHODS

Data were collected from middle school students in Taizhou, China, between November 2021 and April 2022. Participants completed baseline surveys and experience sampling assessments, reporting their emotional states ten times daily over five consecutive weekdays. Depressive symptoms were assessed using the Children's Depression Inventory (CDI), while emotional dynamics (variability, instability, and inertia) were derived from the experience sampling data. Logistic regression models were employed to examine whether emotion dynamics predicted depressive symptoms at 1-month and 3-month follow-ups.

RESULTS

A total of 448 participants completed all study procedures and were included in the analysis. Emotional variability and instability in PA and NA were longitudinally associated with depressive symptoms at both 1-month and 3-month follow-ups. After controlling for mean affect levels, PA variability and instability, but not NA, were uniquely linked to depressive symptoms. Emotional inertia showed no significant association with subsequent depressive symptoms. Emotional variability and instability in PA and NA also predicted the development of new symptoms in adolescents without baseline depression (n = 372).

CONCLUSIONS

Emotional variability and instability of PA and NA were longitudinally associated with changes in depressive symptoms and the development of new symptoms among adolescents. These emotion dynamics provide insights into real-world emotional processing and offer important targets for adolescent depression interventions.

Charting brain functional development from birth to 6 years of age

Early childhood is crucial for brain functional development. Using advanced neuroimaging methods, characterizing functional connectivity has shed light on the developmental process in infants. However, insights into spatiotemporal functional maturation from birth to early childhood are substantially lacking. In this study, we aggregated 1,091 resting-state functional MRI scans of typically developing children from birth to 6 years of age, harmonized the cohort and imaging-state-related bias, and delineated developmental charts of functional connectivity within and between canonical brain networks. These charts revealed potential neurodevelopmental milestones and elucidated the complex development of brain functional integration, competition and transition processes. We further determined that individual deviations from normative growth charts are significantly associated with infant cognitive abilities. Specifically, connections involving the primary, default, control and attention networks were key predictors. Our findings elucidate early neurodevelopment and suggest that functional connectivity-derived brain charts may provide an effective tool to monitor normative functional development.

Examining the unique contribution of parent anxiety sensitivity on adolescent neural responses during an emotion regulation task

Parent factors impact adolescent's emotion regulation, which has key implications for the development of internalizing psychopathology. A key transdiagnostic factor which may contribute to the development of youth internalizing pathology is parent anxiety sensitivity (fear of anxiety-related physiological sensations). In a sample of 146 adolescents (M/SDage = 12.08/.90 years old) and their parents (98% mothers) we tested whether parent anxiety sensitivity was related to their adolescent's brain activation, over and above the child's anxiety sensitivity. Adolescents completed an emotion regulation task in the scanner that required them to either regulate vs. react to negative vs. neutral stimuli. Parent anxiety sensitivity was associated with adolescent neural responses in bilateral orbitofrontal cortex (OFC), anterior cingulate, and paracingulate, and left dorsolateral prefrontal cortex, such that higher parent anxiety sensitivity was associated with greater activation when adolescents were allowed to embrace their emotional reaction(s) to stimuli. In the right OFC region only, higher parent anxiety sensitivity was also associated with decreased activation when adolescents were asked to regulate their emotional responses. The findings are consistent with the idea that at-risk adolescents may be modeling the heightened attention and responsivity to environmental stimuli that they observe in their parents.

Social-emotional competencies and psychological well-being across secondary school transition

This study profiled the association between social-emotional competencies, psychological well-being (PWB), and secondary/middle school transition. Analysis drew from 233 sixth-class/sixth-grade students aged 11-13 years who completed measures of emotion regulation, perceived social support, self-esteem, and PWB at baseline and 1-month follow-up in primary school, and at 6-month follow-up post-secondary school transition. COVID-19 school closures, school socioeconomic status and gender were examined as moderators. Repeated-measures multi-level models revealed a significant decline in boys' emotional suppression use, an increase in boys' self-esteem, and a decline in girls' PWB across the transition. Further, perceived social support, self-esteem, and gender were significant predictors of post-transition PWB while controlling for baseline PWB. This highlights the importance of enhancing social support and self-esteem across secondary school transition and considering gender differences in school transition effects. Policymakers should consider interventions that bolster these factors during this critical developmental phase.

Difficulties in Emotion Regulation Scale-Short Form (DERS-SF): Psychometric Validation and Measurement Invariance Testing in a Sample of Urban Indian Adolescents

Background

Adolescents are particularly vulnerable to emotion dysregulation (ED), a transdiagnostic marker of psychological disorders with implications for academic achievement, identity development, social bonding, mental health, and the overall well-being and development of adolescents. A well-validated tool for the assessment of ED is imperative for credible advances in research on ED among Indian adolescents. Difficulties in Emotion Regulation Scale-Short Form (DERS-SF) is a promising tool to assess ED but requires proper psychometric validation among Indian adolescents. The current study validated the factor structure and examined psychometric aspects including gender invariance testing of the DERS-SF in Indian adolescents aged between 14 and 20 years.

Methods

In a cross-sectional study, a community sample of n = 2079 adolescents completed the English version of the DERS-SF, the Strengths, and Difficulties Questionnaire, the Barratt Impulsiveness Scale, and the Adolescent Problem Behaviour Index.

Results

The six-factor model of the DERS-SF exhibited an acceptable model fit in the current study sample. Invariance testing revealed that the DERS-SF is conceptually interpreted in a similar manner by male and female adolescents. Two-way MANOVA indicated gender and age variations on a few DERS-SF subscales. Reliability for DERS-SF was good, α = 0.86. Adequate construct validity was demonstrated by moderate to strong associations of the DERS-SF subscales with measures of internalizing and externalizing symptoms, adolescent problem behaviors, and impulsivity.

Conclusions

DERS-SF retained the popular six-factor structure with acceptable psychometric properties and hence can be reliably used with Indian adolescents.

Domestic violence and depression among Chinese adolescents: The role of self-evaluation

BACKGROUND

Depression of adolescents seriously affects their mental health as well as the formation and development of sound personality. According to Family Systems Theory, individuals' mental health is closely related with external (e.g. domestic violence) and internal factor (e.g. self-evaluation). The formation mechanism of depression needs deep investigation in order to provide better educational intervention for students and promote their healthy development.

AIM

The study examined the relationship among domestic violence, depression, and self-evaluation.

METHODS

The data were collected from 1,011 Chinese adolescents (Mage = 12.04 ± 1.71) by the questionnaire of Family Violence Scale, Depression Questionnaire, and Rosenberg Self Esteem Scale.

RESULTS

We found domestic violence and depression were significantly positively correlated (r = .25, p < .001); self-evaluation was significantly negatively correlated with domestic violence (r = -.26, p < .001) and depression (r = -.50, p < .001). Moreover, domestic violence could directly and positively predict depressed psychology, and could also indirectly predict depressed psychology through the mediating effect of self-evaluation.

CONCLUSION

The level of depression of adolescents was closely related with domestic violence and self-evaluation. And self-evaluation played a mediating role between domestic violence and self-evaluation.

Comparing the Effects of Adequate and Insufficient Sleep on the Mental Health, Behavioral Outcomes, and Daily Lives of South Korean Adolescents

Background/Objectives: Adequate sleep is critical for adolescents' physical and mental health. However, academic demands and lifestyle habits lead to insufficient sleep among many adolescents. This study examined the relationship between sleep patterns and general characteristics, health behaviors, and mental health among South Korean adolescents. Methods: Data were obtained from the Korea Youth Risk Behavior Survey conducted by the Korea Disease Control and Prevention Agency, involving 21,283 students aged between 13 and 18 years. Self-reported sleep duration was categorized as adequate (8-10 h) or insufficient (less than 8 h on both weekdays and weekends), and 20 independent variables across demographic, socioeconomic, lifestyle, health-related behavioral, and psychological factors were analyzed. Multiple logistic regression analyses were conducted to evaluate the effects of insufficient sleep. Results: Insufficient sleep was more prevalent among female students (odds ratio [OR]: 2.064) and older students (OR: 16.588 for Grade 12 vs. Grade 7) and was associated with higher stress levels (OR: 4.338 for almost always vs. never), suicidal ideation (OR: 1.826), and unhealthy behaviors such as alcohol consumption (OR: 2.009), smoking (OR: 1.998), and smartphone overdependence (OR: 2.313 for severe vs. normal). In contrast, adolescents with adequate sleep reported greater happiness (OR: 4.167 for very much vs. not at all) and better academic performance (OR: 1.377 for very high vs. very low). Conclusions: The findings show that insufficient sleep significantly affects adolescent well-being, highlighting the need for tailored interventions and increased societal awareness. Future research should explore the mechanisms underlying gender differences and weekday-weekend sleep disparities to enhance sleep quality in this population.

The associations between interparental conflict and adolescent adjustment: a cross-lagged panel network analysis

Extensively studied in interparental relationship literature suggests interparental conflict is a risk factor for adolescent adjustment, but the specific, dimension level relationships between interparental conflict and adolescent adjustment remain unclear. This study explored the interactions between the various dimensions of interparental conflict and adolescent adjustment in Chinese adolescents. A total of 1870 Chinese adolescents (42.27% males; Mage = 16.18, SD = 0.43, range = 15-18) completed a survey at two time points spaced three months apart. Data was analyzed using both cross-sectional and longitudinal network analysis. The cross-sectional network analysis found that resolution has the greatest connections with the dimensions of adolescent adjustment, suggesting that adolescents reporting high resolution are more prone to experience concurrent poor adjustment and therefore should be a primary focus of attention. The longitudinal network analysis revealed that, in general, previous hyperactivity-inattention is a significant and strong predictor of future interparental conflict, underscoring a child-driven effect. Meanwhile, prosocial behavior contributes to decreases in both interparental conflict and adjustment problems over time. These findings highlight the importance of addressing hyperactivity-inattention and cultivating prosocial behavior in adolescents as key intervention points-these can help resolve conflicts between parents and reduce adjustment problems for adolescents.

Dorsal CA1 NECTIN3 Reduction Mediates Early-Life Stress-Induced Object Recognition Memory Deficits in Adolescent Female Mice

Early-life stress (ES) leads to cognitive dysfunction in female adolescents, but the underlying neural mechanisms remain elusive. Recent evidence suggests that the cell adhesion molecules NECTIN1 and NECTIN3 play a role in cognition and ES-related cognitive deficits in male rodents. In this study, we aimed to investigate whether and how nectins contribute to ES-induced cognitive dysfunction in female adolescents. Applying the well-established limited bedding and nesting material paradigm, we found that ES impairs recognition memory, suppresses prefrontal NECTIN1 and hippocampal NECTIN3 expression, and upregulates corticotropin-releasing hormone (Crh) and its receptor 1 (Crhr1) mRNA levels in the hippocampus of adolescent female mice. Genetic experiments revealed that the reduction of dorsal CA1 (dCA1) NECTIN3 mediates ES-induced object recognition memory deficits, as knocking down dCA1 NECTIN3 impaired animals' performance in the novel object recognition task, while overexpression of dCA1 NECTIN3 successfully reversed the ES-induced deficits. Notably, prefrontal NECTIN1 knockdown did not result in significant cognitive impairments. Furthermore, acute systemic administration of antalarmin, a CRHR1 antagonist, upregulated hippocampal NECTIN3 levels and rescued object and spatial memory deficits in stressed mice. Our findings underscore the critical role of dCA1 NECTIN3 in mediating ES-induced object recognition memory deficits in adolescent female mice, highlighting it as a potential therapeutic target for stress-related psychiatric disorders in women.

Tri-level anxiety and depression symptom trajectory in adolescents: The role of emotion regulation diversity

Anxiety and depression are associated with impaired emotion regulation (ER). Recently, a novel construct named ER diversity has been proposed to assess the diversity in ER strategy use. Low ER diversity, particularly under stressful circumstances, may be a transdiagnostic vulnerability factor for anxiety and depression. This study utilized a longitudinal design to examine the association between ER diversity and transdiagnostic anxiety and depressive symptom trajectory in adolescents (N = 627 at baseline), while accounting for life stress. Measures of ER strategy use, chronic interpersonal life stress, neuroticism, and transdiagnostic dimensional symptoms of anxiety and depression were assessed. The ER diversity index and the traditional ER sum score were computed. Higher ER diversity index was associated with steeper decline in the Fears symptom factor over time, above and beyond the ER sum score and neuroticism. Moreover, chronic interpersonal life stress influenced these associations. When chronic interpersonal life stress was low, Fears declined over time regardless of the ER diversity level; when chronic interpersonal life stress was high, Fears only declined when ER diversity was high. Thus, low diversity in ER strategy use, particularly under stressful circumstances, may be a vulnerability factor for fear symptom development.

Rumination, loneliness, and non-suicidal self-injury among adolescents with major depressive disorder: The moderating role of resilience

Adolescents often experience negative emotions, such as depression and anxiety, due to rapid biological, cognitive, and social changes during this developmental stage. In recent years, the non-suicidal self-injury (NSSI) among adolescents with Major Depressive Disorder (MDD) has garnered increasing attention, with rumination identified as a significant risk factor for its occurrence. This study established a moderated mediation model to examine the impact of rumination on NSSI among adolescents with MDD and its underlying mechanisms. The final research sample consisted of 1,601 adolescents with MDD (18.2% males, mean age = 14.85 years, SD = 1.65) from 14 psychiatric/general hospitals across nine provinces in China. Participants completed self-report questionnaires assessing NSSI, rumination, loneliness, and resilience. Results indicated that rumination contribute to NSSI via loneliness during adolescence, whereas resilience may buffer the adverse effects of rumination on NSSI, implying the potential effectiveness of reducing loneliness and promoting resilience in the intervention and prevention of NSSI. These findings further illuminate the mechanisms underlying the development of NSSI, aiding in its prediction and prevention among adolescents, thereby assisting them in better coping with emotional and behavioral developmental challenges during adolescence.

Prevailing theories describing sports-related concussion symptom reporting intent and behavior among adolescent athletes: a scoping review

Diagnosis of sports-related concussion (SRC) primarily relies on an athlete's self-report of injury and associated symptoms. Social pressures and attitudes surrounding SRC influence athlete reporting behavior. Unfortunately, underreporting of SRC symptoms is an issue among adolescent athletes. Nondisclosure of SRC symptoms may lead to premature return-to-play and potential persistent symptoms. This scoping review summarizes prevailing theories that explain SRC symptom reporting intent and behavior among adolescent athletes. Literature was reviewed following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) extension for Scoping Review guidelines. Inter-rater reliability was calculated at each stage. Thirty-four articles published between 2013-2024 were included. Inter-rater reliability was fair to perfect across all review stages. Of the 16 unique theories described, the Theory of Reasoned Action/Theory of Planned Behavior (TRA/TPB) was the most frequently cited theory explaining SRC symptom reporting behavior. Although the TRA/TPB framework was useful when predicting SRC symptom reporting intent, it did not adequately predict reporting behavior, consistent with the broader health behavior literature which has established that intention is not a good predictor of behavior. In light of these findings, new frameworks must be considered that consider neurodevelopmental, cognitive, and cultural factors, as these may be more useful for understanding SRC symptom reporting behavior in adolescence.

Causal mechanisms of quadruple networks in pediatric bipolar disorder

BACKGROUND

Pediatric bipolar disorder (PBD) is characterized by abnormal functional connectivity among distributed brain regions. Increasing evidence suggests a role for the limbic network (LN) and the triple network model in the pathophysiology of bipolar disorder (BD). However, the specific relationship between the LN and the triple network in PBD remains unclear. This study aimed to investigate the aberrant causal connections among these four core networks in PBD.

METHOD

Resting-state functional MRI scans from 92 PBD patients and 40 healthy controls (HCs) were analyzed. Dynamic Causal Modeling (DCM) was employed to assess effective connectivity (EC) among the four core networks. Parametric empirical Bayes (PEB) analysis was conducted to identify ECs associated with group differences, as well as depression and mania severity. Leave-one-out cross-validation (LOOCV) was used to test predictive accuracy.

RESULT

Compared to HCs, PBD patients exhibited primarily excitatory bottom-up connections from the LN to the salience network (SN) and bidirectional excitatory connections between the default mode network (DMN) and SN. In PBD, top-down connectivity from the triple network to the LN was excitatory in individuals with higher depression severity but inhibitory in those with higher mania severity. LOOCV identified dysconnectivity circuits involving the caudate and hippocampus as being associated with mania and depression severity, respectively.

CONCLUSIONS

Disrupted bottom-up connections from the LN to the triple network distinguish PBD patients from healthy controls, while top-down disruptions from the triple network to LN relate to mood state differences. These findings offer insight into the neural mechanisms of PBD.

Independent and Interactive Impacts of Prenatal Exposure to Legal Substances and Childhood Trauma on Emotion Processing in Pre-Adolescents: Preliminary Findings From the ABCD Study

Objective

This paper investigated the effects of prenatal drug exposure (PDE), childhood trauma (CT), and their interactions on the neurobiological markers for emotion processing.

Method

Here, in a non-clinical sample of pre-adolescents (9-10 years of age) from the Adolescent Brain Cognitive Development (ABCD) Study (N = 6,146), we investigate the impact of PDE to commonly used substances (ie, alcohol, cigarettes, and marijuana), CT, and their interaction on emotion processing. From the Emotional N-back functional magnetic resonance imaging task data, we selected 26 regions of interests, previously implicated in emotion processing, and conducted separate linear mixed models (108 total) and accounted for available environmental risk factors.

Results

PDE was associated with reductions in response bias related to the processing of fearful compared to happy faces in widespread cortical regions (including the superior frontal and fusiform gyri and the inferior parietal lobule). Reduced response bias in the superior frontal gyrus emerged as PDE driven and was present regardless of CT status, but correlated with several items on the Child Behavior Checklist only in those children with both PDE and CT. The lower response bias of the left inferior parietal lobule, on the other hand, was observed only in children with both PDE and CT, and correlated with internalizing and externalizing behaviors.

Conclusion

The study's results support the diathesis-stress model, and suggest that PDE may confer vulnerability to the effects of later CT through altered neurodevelopment. Children experiencing these "double-hit" conditions may represent at-risk individuals who could benefit from early interventions to mitigate the onset of psychopathology. Because of limitations in the way that PDE was reported in the ABCD Study, including lack of severity measures and retrospective reporting, results are not sufficient for making recommendations or dictating policy for pregnant persons. Nevertheless, this study is a necessary first step in examining the interactive effects of prenatal and early-life exposures, as well as many aspects of the sociodemographic and psychological environment.

Dynamic characteristics of parent-adolescent closeness: Predicting adolescent emotion dysregulation

Emotion dysregulation is linked to adolescent psychological problems. However, little is known about how lability in daily closeness of parent-adolescent dyads affects the development of emotion dysregulation. This study examined how closeness lability with parents was associated with emotion dysregulation 12 months later. The sample included 144 adolescents (M = 14.62, SD = 0.83) who participated in a baseline assessment, 21-day daily diaries, and a 12-month follow-up assessment. Parents and adolescents both reported adolescent emotion dysregulation at baseline and follow-up assessments, while adolescents reported daily parent-adolescent closeness. Results indicate that lability in father-adolescent closeness was associated with increased emotion dysregulation at 12 months reported by adolescents. However, lability in mother-adolescent closeness was not associated with adolescent emotion dysregulation. Moreover, when baseline father-adolescent closeness was high, greater lability in father-adolescent closeness was associated with decreased emotion dysregulation. Findings indicate that daily fluctuations in father-adolescent closeness are a key family characteristic that links to long-term adolescent emotion dysregulation.

Discrimination Exposure, Neural Reactivity to Stress, and Psychological Distress

OBJECTIVE

Discrimination exposure has a detrimental impact on mental health, increasing the risk of depression, anxiety, and posttraumatic stress. The impact discrimination exposure has on mental health is likely mediated by neural processes associated with emotion expression and regulation. However, the specific neural processes that mediate the relationship between discrimination exposure and mental health remain to be determined. The present study investigated the relationship adolescent discrimination exposure has with stress-elicited brain activity and mental health symptoms in young adulthood.

METHODS

A total of 301 participants completed the Montreal Imaging Stress Task while functional MRI data were collected. Discrimination exposure was measured four times from ages 11 to 19, and stress-elicited brain activity and psychological distress (depression, anxiety, posttraumatic stress) were assessed in young adulthood (age 20).

RESULTS

Stress-elicited dorsolateral and dorsomedial prefrontal cortex (PFC), inferior parietal lobule (IPL), and hippocampal activity varied with discrimination exposure. Activity within these brain regions varied with the cumulative amount and trajectory of discrimination exposure across adolescence (initial exposure, change in exposure, and acceleration of exposure). Depression, anxiety, and posttraumatic stress symptoms varied with discrimination exposure. Stress-elicited activity within the dorsolateral PFC and the IPL statistically mediated the relationship between discrimination exposure and psychological distress.

CONCLUSIONS

The findings suggest that adolescent discrimination exposure may alter the neural response to future stressors (i.e., within regions associated with emotion expression and regulation), which may in turn modify susceptibility and resilience to psychological distress. Thus, differences in stress-elicited neural reactivity may represent an important neurobiological mechanism underlying discrimination-related mental health disparities.

Digital Media Use Preference Indirectly Relates to Adolescent Social Anxiety Symptoms Through Delta-Beta Coupling

Adolescence is a period of profound biological and social-emotional development during which social anxiety symptoms commonly emerge. Over the past several decades, the social world of teens has been transformed by pervasive digital media use (e.g., social media, messaging apps), highlighting the urgent need to examine links between digital media use and mental health. Prior work suggests that a preference to use digital media to communicate emotions, rather than face-to-face contexts, is associated with emotion regulation vulnerabilities. Difficulties with emotion regulation are a hallmark of elevated anxiety, and the maturation of frontal-subcortical circuitry underlying emotion regulation may make adolescents especially vulnerable to the possible detrimental effects of digital media use. The current study leveraged an emerging neurophysiological correlate of emotion regulation, delta-beta coupling, which captures cortical-subcortical coherence during resting state. We test links among digital media use preferences, delta-beta coupling, and anxiety symptoms with a sample of 80 adolescents (47 females; 33 males) ages 12-15 years (M = 13.9, SD = 0.6) (80% White, 2% Black/African American, 16% more than one race, 2% Hispanic/Latine). Youth had their EEG recorded during 6 min of resting-state baseline from which delta-beta coupling was generated. Youth self-reported their social anxiety symptoms and preferences for digital media use vs face-to-face modalities. Greater digital media use preferences for both positive and negative social-emotional communication were associated with elevated social anxiety symptoms indirectly through high delta-beta coupling. This suggests that neural regulatory imbalance may be a pathway through which adolescents' habitual preferences for digital media use over face-to-face communication relate to elevated social anxiety.

Atypical prefrontal neural activity during an emotional interference control task in adolescents with autism spectrum disorder: A functional near-infrared spectroscopy study

Autism spectrum disorder (ASD) is typically characterized by impairments in social interaction and communication, which may be associated with a failure to naturally orient to social stimuli, particularly in recognizing and responding to facial emotions. As most previous studies have used nonsocial stimuli to investigate inhibitory control in children and adults with ASD, little is known about the behavioral and neural activation patterns of emotional inhibitory control in adolescent with ASD. Functional neuroimaging studies have underscored the key role of the prefrontal cortex (PFC) in inhibitory control and emotional face processing. Thus, this study aimed to examine whether adolescent with ASD exhibited altered PFC processing during an emotional Flanker task by using non-invasive functional near-infrared spectroscopy (fNIRS). Twenty-one adolescents with high-functioning ASD and 26 typically developing (TD) adolescents aged 13-16 years were recruited. All participants underwent an emotional Flanker task, which required to decide whether the centrally positioned facial emotion is consistent with the laterally positioned facial emotion. TD adolescents exhibited larger RT and mean O2Hb level in the incongruent condition than the congruent condition, evoking cortical activations primarily in right PFC regions in response to the emotional Flanker effect. In contrast, ASD adolescents failed to exhibit the processing advantage for congruent versus incongruent emotional face in terms of RT, but showed cortical activations primarily in left PFC regions in response to the emotional Flanker effect. These findings suggest that adolescents with ASD rely on different neural strategies to mobilize PFC neural resources to address the difficulties they experience when inhibiting the emotional face.

The Lifelines Cohort Study: Prevalence of Tinnitus Associated Suffering and Behavioral Outcomes in Children and Adolescents

OBJECTIVES

Tinnitus in children and adolescents is relatively unexplored territory. The available literature is limited and the reported prevalence of tinnitus suffering varies widely due to the absence of a definition for pediatric tinnitus. The impact on daily life seems to be lower than in the adult population. It is unclear if children who suffer from tinnitus, like adults, also experience psychological distress like anxiety or depressive symptoms. A better understanding of tinnitus in children and its impact on daily life could provide more insight into the actual size of the problem and could give direction for future studies to investigate the cause of progression of tinnitus.

DESIGN

A cross-sectional study was performed using the Dutch Lifelines population-based cohort of people living in the north of the Netherlands. A total of 4964 children (4 to 12 years of age) and 2506 adolescents (13 to 17 years of age) were included. The presence of tinnitus suffering and behavioral outcomes were assessed with a single-item question and the Child Behavioral Checklist or the Youth Self Report questionnaire respectively. The associations of behavioral outcomes and tinnitus suffering were analyzed using univariate binary regressions.

RESULTS

The prevalence of tinnitus suffering in children was 3.3 and 12.8% in adolescents. Additionally, 0.3% of the children and 1.9% of the adolescents suffered a lot or extremely of their tinnitus. Externalizing and internalizing problems were associated with tinnitus in adolescents. Internalizing problems were associated with tinnitus in children.

CONCLUSIONS

The prevalence of tinnitus suffering in this sample of the general population is comparable to other population-based studies. A low percentage of children (0.3%) or adolescents (1.9%) suffered a lot or extremely of their tinnitus. Tinnitus suffering is associated with all behavioral outcome subscales in adolescents and with internalizing problems in children, although the effect sizes were very small. Future research should focus on achieving a consensus for the definition of pediatric tinnitus and on the development of a validated outcome measure.

Validation of the Difficulties in Emotion Regulation Scale-Short Form in a sample of Italian adolescents

OBJECTIVE

The primary objective of the present study is to validate the Difficulty in Emotion Regulation Scale-Short Form (DERS-SF) in a sample of Italian adolescents. Additionally, we aim to evaluate its factorial structure by examining the contribution of each subscale (i.e., Nonacceptance, Clarity, Awareness, Goals, Impulse, Strategy) on the general factor using bi-factor models by replicating a past study.

METHOD

The sample comprises N = 704 adolescents aged 11-17 years (M = 13.38, SD = 1.37; 53.12% females). To establish external validity, correlation and path analyses were conducted between the DERS-SF sub-scales, the total score, and measures of internalizing and externalizing symptoms, as well as Problematic Smartphone Use (PSU). Measurement invariance was tested comparing males versus females and pre-adolescents and adolescents.

RESULTS

Overall, results supported the multidimensional nature of the DERS-SF, confirming its original six-factor structure. However, bi-factor models analysis revealed that the Awareness subscale should be excluded when calculating the total score. Furthermore, findings indicated that the Strategy subscale variance is largely accounted for by the general factor rather than the specific subscale. In terms of external validity, significant positive associations between the DERS-SF sub-scales, the total score, and PSU, internalizing and externalizing symptoms were observed. Measurement invariance was supported.

CONCLUSIONS

Altogether, findings support the validity of the DERS-SF among Italian Adolescents and provide insights relevant to the understanding of the multifaceted facets of emotion regulation, emphasizing its relevance as a transdiagnostic process.

Increased functional integration of emotional control network in late adulthood

Across the adult lifespan, emotion regulation ability remains stable or even improves. The corresponding effects, however, in the emotion regulation networks in the brain remain underexplored. By utilizing large-scale datasets such as the Human Connectome Project (HCP-Aging, N=621, 349 females) and Cambridge Centre for Ageing and Neuroscience (Cam-CAN, N=333, 155 females), we were able to investigate how emotion regulation networks' functional topography differs across the entire adult lifespan. Based on previous meta-analytic work that identified four large-scale functional brain networks involved in emotion generation and regulation, we investigated the association between the integration of these emotion regulation networks and measures of mental wellbeing with age in the HCP-Aging dataset. We found an increase in the functional integration of the emotional control network among older adults, which was replicated using the Cam-CAN data set. Further we found that the network that is mediating emotion generative and regulative processes, and carries our introspective and reflective functions, is less integrated in higher age. Our study highlights the importance of identifying topological changes in the functional emotion network architecture across the lifespan, as it allows for a better understanding of functional brain network changes that accompany emotional aging.

How the arts heal: a review of the neural mechanisms behind the therapeutic effects of creative arts on mental and physical health

Background

The creative arts have long been known for their therapeutic potential. These modalities, which include dance, painting, and music, among others, appear to be effective in enhancing emotional expression and alleviating adverse physiological and psychological effects. Engagement in creative arts can be pursued as a personal hobby, in a classroom setting, or through a formal therapeutic intervention with a qualified therapist. Engagement can be active (i.e., creating) or passive (i.e., viewing, listening). Regardless of the modality and manner of engagement, the mechanisms explaining the therapeutic efficacy of creative arts remain poorly understood.

Objective

This study aims to systematically review research investigating the neurological mechanisms activated during active or passive engagement in creative arts, with a specific emphasis on the roles of the medial prefrontal cortex (mPFC) and the amygdala in emotional regulation (ER) and creative behaviors. The review seeks to provide preliminary evidence for the possible existence of common neural mechanisms underlying both phenomena, which could inform the development of targeted therapeutic interventions leveraging creative arts for ER.

Methods

A systematic review was conducted following the Cochrane Collaboration guideline and PRISMA standards to identify studies examining the neurological mechanisms underlying creative activities.

Results

A total of six out of 85 records meet the inclusion criteria, with all being basic research studies. Preliminary findings suggest that active and passive engagement with creative arts consistently activate neural circuits implicated in adaptive emotional regulation, including the mPFC and amygdala. These activations mirror the neural pathways engaged in effective ER strategies, suggesting the possible existence of shared mechanisms between creative expression and emotional processing.

Conclusion

The evidence underscores the potential of creative arts as a complementary therapeutic strategy alongside conventional care and other evidence-based mind-body modalities. By elucidating the shared neural mechanisms between creative arts engagement and ER, this review contributes to the theoretical and practical understanding of the role of creative arts in mental health. Future research is recommended to further explore these neural correlations and their implications for therapeutic practice.

Design of the FRESH-teen study: A randomized controlled trial evaluating an adapted emotion regulation weight loss program for adolescents with overweight or obesity and their parent

Overweight and obesity affect >40% of adolescents. Family-based behavioral treatment (FBT) is the most efficacious behavioral treatment for weight management among youth and consists of nutrition and physical activity education, behavior change skills, and parent skills training. However, the efficacy of FBT decreases for youth as they get older. Increased emotional lability and limited emotion regulation skills may contribute to the reduced efficacy of FBT for adolescents. To date, there are no treatments for overweight or obesity specifically adapted for the needs of adolescents. We developed a treatment that integrates components from Dialectical Behavior Therapy and Emotion Focused Therapy with FBT (FBT+ER or FBT-ER) to address the specific needs of adolescents. The current study randomized 166 adolescents (BMI = 32.8; 14.3 years; 57% female; 32% Hispanic, 50% Non-Hispanic White, 18% Non-Hispanic and Non-White) and one of their parents (BMI = 32.9; 45.3 years; 85% female; 27% Hispanic, 57% Non-Hispanic White, 16% Non-Hispanic and Non-White) to 6 months of either standard FBT or FBT+ at 2 sites. Assessments were conducted at baseline, mid-treatment (month 3), post-treatment (month 6), 6-month follow-up (month 12) and 12-month follow-up (month 18). Primary outcomes are adolescent weight (BMIz/%BMIp95), emotion regulation skills, and emotional eating behaviors. Given the public health concern of adolescent obesity, FBT+ could prove extremely useful to provide more targeted and effective intervention for adolescents with overweight or obesity. CLINICAL TRIALS: # NCT03674944.

Depressive and anxiety symptom trajectories in Polish adolescents during the COVID-19 pandemic and the outbreak of war in Ukraine: uncovering the role of family relations

INTRODUCTION

The aim of the study was to investigate longitudinal trajectories of change in anxiety and depression symptoms in Polish adolescents during the second year of the COVID-19 pandemic and after the outbreak of the war in Ukraine. Additionally, we aimed to identify risk/protective factors and outcomes associated with these trajectories.

METHOD

We collected data in three waves between November 2021 and May 2022. Adolescents (N = 281 in the first wave) completed the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the Filial Responsibility Scale for Youth, and questions related to the COVID-19 pandemic and war in Ukraine.

RESULTS

We identified three trajectories of depressive symptoms: resilient with low, stable symptoms (71% of participants), chronically elevated symptoms (11%), and acute symptoms followed by recovery (18%). We distinguished two trajectories of anxiety symptoms: resilient (75%) and chronic (25%). Non-resilient trajectories were predicted by higher levels of familial unfairness (perceived lack of equality and reciprocity in the family), relationship difficulties at school and at home, older age, and poor socioeconomic status. Chronic depressive and anxiety symptoms were associated with higher war-related concerns.

DISCUSSION

These findings can inform preventive and therapeutic interventions for at-risk adolescents to reduce negative long-term outcomes of social crises.

Effects of physical activity on anxiety levels in college students: mediating role of emotion regulation

Objectives

To explore the effects of physical activity on anxiety levels in college students, as well as to examine the mediating role of emotion regulation.

Methods

A convenience sample of 1,721 college students from Shanghai, Jiangsu, Shandong, Guangxi, and Hunan was used to conduct an evaluation and a survey through the Physical Activity Rating Scale (PARS-3), the Anxiety Self-Rating Scale (SAS), and the Emotion Regulation Scale (ERQ).

Results

College students' anxiety level, cognitive reappraisal, and expression inhibition scores were (44.72 ± 10.37), (30.16 ± 6.51), and (16.96 ± 4.99), respectively. There were significant grade and physical activity level differences in anxiety levels and cognitive reappraisal, and significant gender and physical activity level differences in expression inhibition among college students. Process model 4 mediated effect regression analysis showed that physical activity had a significant positive effect on cognitive reappraisal (R 2 = 0.14, β = 0.04, P < 0.001), and physical activity did not have a significant expression inhibition effect (R 2 = 0.17, β = 0.01, P = 0.27). Physical activity (β = -0.03, P = 0.012), cognitive reappraisal (β = -0.59, P < 0.001), and expression inhibition had a significant effect on (β = 0.57, P < 0.001) anxiety levels (R 2 = 0.37). In the model effect relationship, the direct and indirect effects of physical activity on anxiety levels were -0.028 and -0.019, respectively.

Conclusion

Physical activity has a significant negative effect on college students' anxiety levels. Cognitive reappraisal is a mediating variable for the effect of physical activity on anxiety levels. The higher the level of physical activity and the higher the intensity of the activity, the lower the level of anxiety.

The Development of Ambiguity Processing Is Explained by an Inverted U-Shaped Curve

Understanding the developmental trajectories for recognizing facial expressions is important for a better understanding of development of psychiatric disorders. In this study, we examined the recognition of emotional and neutral facial expressions in 93 typically developing adolescents and adults. The Emotion Intensity Rating task required participants to rate the intensity of emotional expression in happy, neutral, and sad faces on a scale from 1 to 9. A score of '5' had to be assigned to neutral faces, scores between '6' (slightly happy) and '9' (very happy) to happy faces, and scores between '4' (slightly sad) and '1' (very sad) to sad faces. Mixed effects models were used to examine the effects of age and emotion on recognition accuracy, reaction time (RT), and emotional intensity. Participants tended to misjudge neutral faces as sad. Adolescents were less accurate than adults for neutral face recognition. There were significant quadratic effects of age on accuracy (negative quadratic effect) and RT (positive quadratic effect). The most accurate and fastest performance was observed in 25- to 35-year-old subjects. This trajectory may be associated with prefrontal cortex maturation, which provides top-down control over the heightened amygdala response to ambiguity that may be misinterpreted as emotional content.

Psychosocial Training Program for Lifeguards: A Pilot Study

Research has highlighted the need for training lifeguards in psychosocial skills. Therefore, this study aims to analyze the effectiveness of a short 10-h training program encompassing dimensions associated with emotional management, focus of attention, interpersonal relationships, and lifeguard behavior, and its effects on their psychosocial skills. A total of 64 lifeguards with experience ranging from 1 to 25 years (M = 5.93, SD = 6.07), randomly divided into experimental and control groups, participated in this study. The d2 Test of Attention, the Social Intelligence Test of O'Sullivan and Guilford, and the MSCEIT Emotional Intelligence Test were used to assess psychosocial skills. A multivariate analysis of variance for repeated measures (2 × 3 (Group × Time) MANOVA) was performed to analyze the effects of the training program on psychosocial skills. The results revealed that the experimental group showed statistically significant improvements in focus of attention and emotional intelligence compared to the control group. However, it is worth noting that no statistically significant group interactions were observed for measures of social intelligence. Taken together, these results seem to highlight the importance of including psychosocial content in the general training of lifeguards.

Linking a latent variable trait-state-occasion model of emotion regulation to cognitive control

Emotion dysregulation (ED) is a vulnerability factor for affective disorders that may originate from deficits in cognitive control (CC). Although measures of ED are often designed to assess trait-like tendencies, the extent to which such measures capture a time-varying (TV) or state-like construct versus a time-invariant (TI) or trait-like personality characteristic is unclear. The link between the TV and TI components of ED and CC is also unclear. In a 6-wave, 5-month longitudinal study, community participants (n = 1281) completed the Difficulties in Emotion Regulation Scale (DERS-16), a commonly used measure of ED and measures of CC. A latent variable (trait-state-occasion) model showed that the proportion of TI factor variance (.80) was greater than the TV factor variance (.19). Although TV factor stability was significant, the coefficients were small in magnitude. Furthermore, regression weights for the ED TI factor (average β  = -.62) were significant and larger than those for the TV factor (average β  = -.10) in predicting latent CC at each of the six-time points. These findings suggest that ED, as assessed by the DERS-16, is largely TI and this TI component is more strongly linked to CC than the TV component.

Study protocol for Sauti ya Vijana (The Voice of Youth): A hybrid-type 1 randomized trial to evaluate effectiveness and implementation of a mental health and life skills intervention to improve health outcomes for Tanzanian youth living with HIV

OBJECTIVE

Young people living with HIV (YPLWH) experience increased morbidity and mortality compared to all other age groups. Adolescence brings unique challenges related to sexual reproductive health, the elevated importance of peer groups, and often, emerging symptoms of emotional distress. Failure to address this unique life stage for YPLWH can lead to worse HIV and mental health outcomes. Herein lies the protocol for a hybrid-type-1 effectiveness-implementation trial designed to evaluate a mental health and life skills intervention that aims to address these needs for YPLWH in Tanzania.

METHODS

This is an individually randomized group-treatment trial designed to evaluate the effectiveness of Sauti ya Vijana (SYV: The Voice of Youth) toward improving viral suppression (HIV RNA <400 copies/mL) and mental health outcomes and to assess implementation including acceptability, feasibility, fidelity, and cost-effectiveness of the manualized intervention. The trial is being conducted across four geographically distinct regions of Tanzania. Peer group leaders (PGL) with lived HIV experience deliver the 10-session group-based intervention and two individual sessions during which participants describe their disclosure narrative (when they learned they live with HIV) and value-based goal setting. Caregiver or chosen supportive adults are encouraged to attend two specific group sessions with their youth. Participants are 10-24 years of age, prescribed antiretroviral therapy for at least 6 months, fully aware of their HIV status, able to commit to session attendance, and able to understand and meaningfully contribute to group sessions. Participant study visits occur at 5 time points for evaluation: baseline, 4-, 6-, 12-, and 18-months post baseline. A single booster session is conducted before the 12-month visit. Study visits evaluate mental health, adverse childhood events, interpersonal violence, resilience, stigma, HIV knowledge, substance use, sexual relationships, ART adherence, and HIV RNA. Implementation outcomes evaluate feasibility and acceptability through attendance, intervention session notes, focus discussion groups and qualitative interviews. Fidelity to the intervention is measured using fidelity checklists by a PGL observer at each group session. Cost effectiveness is calculated using an incremental cost-effectiveness ratio that utilizes a patient cost questionnaire and financial records of study costs.

SIGNIFICANCE

Few mental health interventions for YPLWH have demonstrated effectiveness. Results from this study will provide information about effectiveness and implementation of a peer-led intervention for delivering a mental health and life skills intervention in low-income settings.

TRIAL IDENTIFIER

This trial is registered at clinicaltrials.gov NCT05374109.

Body Aware: Adolescents' and Young Adults' Lived Experiences of Body Awareness

Paying attention to body sensations has been associated with many positive outcomes such as increased subjective well-being, enhanced emotion regulation, and reduced symptom reports. Furthermore, body awareness has an important therapeutic utility in the treatment of various psychological ailments. Despite its importance in mental health, there is very little research on body awareness during adolescence and young adulthood - important developmental periods characterized by bodily changes and the development of one's relationship to one's body. Therefore, the present qualitative study sought to explore how body awareness is understood, experienced, and described by adolescents and young adults. Four online focus groups were conducted with young people between the ages of 14 and 24 (N = 20). Thematic analyses revealed a multidimensional and highly contextualized understanding and experience of body awareness in this age group. In general, young people reported mainly attending to intense and unpleasant body sensations with a particular attitude (e.g., accepting or avoidant) depending on the type of sensation, leading to a variety of cognitive, emotional, and behavioral reactions to these sensations. These processes were embedded in an underlying schema of beliefs about body awareness and an overarching physical and socio-cultural context. Results further revealed a more nuanced experience and understanding of body awareness in women and in young adults. The present findings can be used as a foundation for the development of body awareness theoretical frameworks and self-report instruments for youth and can aid the generating of hypotheses for future research on body awareness in this age group.

Transgenerational transmission of psychopathology: when are adaptive emotion regulation strategies protective in children?

BACKGROUND

Children of parents with a mental illness (COPMI) have multiple psychological and developmental risks, including an increased lifetime risk of developing a mental illness themselves. Emotion regulation (ER) has been identified as a potential underlying mechanism of the transgenerational transmission of mental disorders. This study compares ER strategies in parents with and without a mental illness and their children. Further, it aims to examine the relationship between parents and children's psychopathology with a focus on the role of parental and child ER.

METHODS

Participants were 96 COPMI (77% female) and 99 children of parents without mental illness (COPWMI, 83% female) aged 4-16 years and their parents. Psychopathology and ER strategies of parents and children were assessed with a series of questionnaires.

RESULTS

Both COPMI and their parents showed significantly more psychopathology and more maladaptive and adaptive ER strategies in comparison with COPWMI and their parents. Parent and child adaptive ER strategies mediated the relationship between the psychopathology of parents and children only when child maladaptive ER strategies were low.

CONCLUSIONS

The findings further our understanding of the processes by which parental psychopathology affects child outcomes. Our findings highlight the importance of implementing preventive programs that specifically target the reduction of maladaptive ER in children to interrupt the transgenerational transmission of psychopathological symptoms.

Coping motives as a mediator of the relationship between child maltreatment and substance use problems in south African adolescents

BACKGROUND

Evidence suggests that adults with a history of child maltreatment (CM) engage in substance misuse driven by 'coping motives': maladaptive beliefs that substances help them cope with negative emotions. However, the specificity of this risk pathway is under-researched in younger and non-Western cohorts.

OBJECTIVE

The present study aimed to determine whether coping motives play a distinct role compared to other motives for substance use in mediating the relationship between CM and problematic alcohol and marijuana use in a sample of South African adolescents.

PARTICIPANTS AND SETTING

A sample of 688 high school students (M age = 15.03 years; 62.5 % female) in Cape Town, South Africa, completed a cross sectional survey.

METHODS

Participants completed self-report measures of CM exposure, motives for using alcohol and marijuana (coping, enhancement, social and conformity), and alcohol and marijuana related problems. Participants who endorsed using alcohol (N = 180) or marijuana (N = 136) were included in analysis. A parallel mediation model was conducted for each substance (alcohol and marijuana, respectively) to assess which motives mediated the relationship between CM exposure and substance-related problems.

RESULTS

CM exposure predicted both alcohol-and marijuana related problems. The relationship between CM exposure and alcohol-related problems was partially mediated by coping motives (p < .001, 95%CI 0.028, 0.115) and, to a lesser extent, conformity motives (p < .01, 95%CI 0.001, 0.041), but not by social motives or enhancement motives. The relationship between CM exposure and marijuana-related problems was partially mediated by coping motives (p < .001, 95%CI 0.004, 0.037), but not by conformity, social or enhancement motives.

CONCLUSIONS

The findings support the importance of coping motives as a mediator between CM and problematic substance use across different substances of abuse in South African adolescents, and the role of conformity motives in problematic alcohol use. Future research should explore whether these findings hold across other sociocultural contexts, and the utility of interventions to address coping motives for substance use in adolescence.

Effects of mind-body therapies on depression among adolescents: a systematic review and network meta-analysis

Background

Depression poses significant threats to adolescents' health globally. Research has shown the potential of mind-body therapies to alleviate depression, but limited studies have directly compared the therapeutic effects of different types of mind-body therapies on adolescent depression and the optimal therapy remain unclear. Therefore, we conducted a systematic review and network meta-analysis of randomized controlled trials that met the inclusion criteria to explore the effectiveness of different types of mind-body therapies as interventions to improve depression among adolescents, and to identify the most effective interventions.

Methods

A comprehensive search of databases including PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus up to January 2024 was conducted to assess the impact of mind-body therapies on depression among adolescents. The risk of bias of the included studies was evaluated using Cochrane Review Manager 5.4. STATA 18.0 was used for network meta-analysis. The node-splitting method was used to test the local inconsistency of the network meta-analysis. Funnel plots and the Egger's test were utilized to assess the potential impact of bias in this study.

Result

This network meta-analysis included 9 randomized controlled trials involving a total of 955 subjects. The results indicated that yoga, dance therapy and Tai Chi were more effective than other mind-body therapies in reducing symptoms of depression among adolescents. Specifically, according to the SUCRA ranking, yoga was rated to be the optimal intervention for adolescents with depression (SCURA: 82.2%), followed by dance therapy (SCURA: 77.5%) and Tai Chi (SCURA: 64.9%).

Conclusion

This study revealed that mind-body therapies have positive effects on improving depression among adolescents. Yoga may be the most effective intervention among the different types of mind-body therapies. However, due to the small sample size of patients included, the certainty of the results was limited to some extent. Therefore, further investigation is necessary to strengthen the evidence base when more relevant studies become available.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024508774.

Adaptive-to-maladaptive gradient of emotion regulation tendencies are embedded in the functional-structural hybrid connectome

BACKGROUND

Emotion regulation tendencies are well-known transdiagnostic markers of psychopathology, but their neurobiological foundations have mostly been examined within the theoretical framework of cortical-subcortical interactions.

METHODS

We explored the connectome-wide neural correlates of emotion regulation tendencies using functional and diffusion magnetic resonance images of healthy young adults (N = 99; age 20-30; 28 females). We first tested the importance of considering both the functional and structural connectome through intersubject representational similarity analyses. Then, we employed a canonical correlation analysis between the functional-structural hybrid connectome and 23 emotion regulation strategies. Lastly, we sought to externally validate the results on a transdiagnostic adolescent sample (N = 93; age 11-19; 34 females).

RESULTS

First, interindividual similarity of emotion regulation profiles was significantly correlated with interindividual similarity of the functional-structural hybrid connectome, more so than either the functional or structural connectome. Canonical correlation analysis revealed that an adaptive-to-maladaptive gradient of emotion regulation tendencies mapped onto a specific configuration of covariance within the functional-structural hybrid connectome, which primarily involved functional connections in the motor network and the visual networks as well as structural connections in the default mode network and the subcortical-cerebellar network. In the transdiagnostic adolescent dataset, stronger functional signatures of the found network were associated with higher general positive affect through more frequent use of adaptive coping strategies.

CONCLUSIONS

Taken together, our study illustrates a gradient of emotion regulation tendencies that is best captured when simultaneously considering the functional and structural connections across the whole brain.

Mental Health of Medical Students After Combating the COVID-19 Epidemic: A Cross-sectional Study in Vietnam

OBJECTIVES

This study was conducted to investigate the prevalence of mental health (MH) symptoms and associated factors among medical students who were engaged in combating the coronavirus disease 2019 (COVID-19) epidemic in 4 provinces/cities of Vietnam.

METHODS

A cross-sectional study with 580 participants was conducted at a medical university in Northern Vietnam. MH was assessed using the 21-item Depression, Anxiety, and Stress Scale, which was previously standardized in Vietnam. Data were collected through a structured self-administered questionnaire. Multivariate logistic regression was employed to examine the association between MH symptoms and relevant factors.

RESULTS

Out of a total of 2703 medical students, 21.5% responded to the questionnaire. Among the 580 respondents, the prevalence rates of depression, anxiety, and stress were 43.3%, 44.0%, and 24.7%, respectively. Factors significantly associated with self-reported depression included being female and having a COVID-19 infection. Similarly, being female and having a COVID-19 infection were significantly associated with self-reported anxiety. Factors associated with self-reported stress included being female, having a personal or family history of MH symptoms, working more than 8 hr/day, and having a COVID-19 infection.

CONCLUSIONS

COVID-19 has adversely impacted the MH of medical students. Our findings are valuable in their potential to motivate universities, MH professionals, and authorities to offer mental healthcare services to this group. Furthermore, there is a pressing need for training courses designed to equip future healthcare workers with the skills to manage crises effectively.

Analysis of the Relationship Between Emotion Regulation Difficulties and Impulsivity and Cognitive/Metacognitive Skills in Adolescents Diagnosed with Major Depressive Disorder

Background

Major depressive disorder (MDD) is a significant psychiatric disorder among children and adolescents. It is important that the relationship with depression is analyzed in adolescents in which cognitive and metacognitive processes are different from adult individuals.

Methods

Forty-five patients and 44 healthy controls were included in our study. Participants were administered Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsivity Scale, Behavior Rating Inventory of Executive Function (BRIEF), and Stroop test.

Results

When the DERS total scores were evaluated, a statistically significant difference was found between the 2 groups in terms of DERS scores. In the healthy controls, the emotion regulation skills were significantly higher compared with the MDD group. In the Stroop test, particularly in the fifth section, the control group displayed a statistically significant better performance in both total duration and the number of mistakes made compared with the study group. In the BRIEF test a statistically significant difference was found between the control group and the study group in all 3 areas. In order to determine the efficient factors related to the statistical difference between the BRIEF scores, the multiple linear regression analysis was used.

Conclusion

It was found that depression scores and Stroop performance influence executive functions. Given that Stoop performance can overlap with executive functions, this outcome was expected. However, the impact of depression scores affecting executive functions is also anticipated, considering that these scores particularly affect attention among the cognitive and maladaptive cognitive processes, such as rumination.

Adolescent Nonsuicidal Self-Injury and Suicidality: A Latent Class Analysis and Associations with Clinical Characteristics in an At-Risk Cohort

Nonsuicidal self-injury (NSSI) is frequently encountered in adolescents, but its predictive value for suicidality or other clinical characteristics is challenging due to its heterogeneous nature. This study used latent class analysis to identify subgroups of NSSI and compared these on sociodemographic characteristics, adverse outcomes and protective factors. The study included 966 high-risk adolescents, Mage 14.9 y, SD 0.9 y, 51.8% female. Four classes emerged: (1) "Low NSSI-Low suicidality", (2) "Moderate NSSI-Low suicidality", (3) "Moderate NSSI-High suicidality", and (4) "High NSSI-High suicidality". Girls predominated in the high suicidality classes. Generally, Class 4 had the poorest outcomes: more internalizing and externalizing problems, less social support from friends and families and worst self-esteem. These findings emphasize the need for interventions tailored to specific phenotypes of adolescents engaging in NSSI.

The Power Threat Meaning Framework: a qualitative study of depression in adolescents and young adults

Introduction

Depression constitutes one of our largest global health concerns and current treatment strategies lack convincing evidence of effectiveness in youth. We suggest that this is partly due to inherent limitations of the present diagnostic paradigm that may group fundamentally different conditions together without sufficient consideration of etiology, developmental aspects, or context. Alternatives that complement the diagnostic system are available yet understudied. The Power Threat and Meaning Framework (PTMF) is one option, developed for explanatory and practical purposes. While based on scientific evidence, empirical research on the framework itself is still lacking. This qualitative study was performed to explore the experiences of adolescents and young adults with depression from the perspective of the PTMF.

Methods

We conducted semi-structured interviews with 11 Swedish individuals aged 15- 22 years, mainly female, currently enrolled in a clinical trial for major depressive disorder. Interviews were transcribed verbatim and analyzed with framework analysis informed by the PTMF.

Results

A complex multitude of adversities preceding the onset of depression was described, with a rich variety of effects, interpretations, and reactions. In total, 17 themes were identified in the four dimensions of the PTMF, highlighting the explanatory power of the framework in this context. Not all participants were able to formulate coherent narratives.

Discussion

The PTMF provides a framework for understanding the complexities, common themes, and lived experiences of young individuals with depression. This may be essential for the development of new interventions with increased precision and effectiveness in the young.

The influence of anterior cingulate GABA+ and glutamate on emotion regulation and reactivity in adolescents and adults

During adolescence, emotion regulation and reactivity are still developing and are in many ways qualitatively different from adulthood. However, the neurobiological processes underpinning these differences remain poorly understood, including the role of maturing neurotransmitter systems. We combined magnetic resonance spectroscopy in the dorsal anterior cingulate cortex (dACC) and self-reported emotion regulation and reactivity in a sample of typically developed adolescents (n = 37; 13-16 years) and adults (n = 39; 30-40 years), and found that adolescents had higher levels of glutamate to total creatine (tCr) ratio in the dACC than adults. A glutamate Í age group interaction indicated a differential relation between dACC glutamate levels and emotion regulation in adolescents and adults, and within-group follow-up analyses showed that higher levels of glutamate/tCr were related to worse emotion regulation skills in adolescents. We found no age-group differences in gamma-aminobutyric acid+macromolecules (GABA+) levels; however, emotion reactivity was positively related to GABA+/tCr in the adult group, but not in the adolescent group. The results demonstrate that there are developmental changes in the concentration of glutamate, but not GABA+, within the dACC from adolescence to adulthood, in accordance with previous findings indicating earlier maturation of the GABA-ergic than the glutamatergic system. Functionally, glutamate and GABA+ are positively related to emotion regulation and reactivity, respectively, in the mature brain. In the adolescent brain, however, glutamate is negatively related to emotion regulation, and GABA+ is not related to emotion reactivity. The findings are consistent with synaptic pruning of glutamatergic synapses from adolescence to adulthood and highlight the importance of brain maturational processes underlying age-related differences in emotion processing.

Exploring the Link Between Smartphone Overdependence, Depression, and Suicidal Behaviors Through the Mediating Effect of Lifestyle Risk Behaviors Among South Korean Adolescents: A Cross-sectional Study Using National Big Data

INTRODUCTION

This study examined how lifestyle risk behaviors mediate the relationship between smartphone overdependence, depressive symptoms, and suicidal behavior in adolescents.

METHOD

Based on a secondary analysis of national survey data obtained in 2020 in South Korea, this study had 54,948 participating adolescents. Multiple logistic regression and mediating effect analyses were used to assess the relationships between the study variables.

RESULTS

Adolescents' lifestyle risk behaviors partially mediated the link between smartphone overdependence and depression (Z = 6.86, p < .001), suicidal ideation (Z = 7.04, p < .001), and suicidal planning (Z = 4.59, p < .001).

DISCUSSION

This is the first study to examine the mediating role of comprehensive lifestyle behaviors, not single habits, in the relationship between smartphone overdependence, depression, and suicidal behaviors. Encouraging healthy lifestyle behaviors in adolescents can help alleviate the link between smartphone overdependence and mental health problems.

Daily life affective dynamics as transdiagnostic predictors of mental health symptoms: An ecological momentary assessment study

BACKGROUND

Affective dynamics have been identified as a correlate of a broad span of mental health issues, making them key candidate transdiagnostic factors. However, there remains a lack of knowledge about which aspects of affective dynamics - especially as they manifest in the course of daily life - relate to a general risk for mental health issues versus specific symptoms.

METHODS

We leverage an ecological momentary assessment (EMA) study design with four measures per day over a two-week period to explore how negative affect levels, inertia, lability, and reactivity to provocation and stress in the course of daily life relate to mental health symptoms in young adults (n = 256) in the domains of anxiety, depression, psychosis-like symptoms, behaviour problems, suicidality, and substance use.

RESULTS

Dynamic structural equation modelling (DSEM) suggested that negative affect levels in daily life were associated with depression, anxiety, indirect and proactive aggression, psychosis, anxiety, and self-injury; negative affective lability was associated with depression, physical aggression, reactive aggression, suicidal ideation, and ADHD symptoms; negative affective inertia was associated with depression, anxiety, physical aggression, and cannabis use; and emotional reactivity to provocation was related to physical aggression.

LIMITATIONS

The cross-sectional design, the limited span of mental health issues included, and the convenience nature and small size of the sample are limitations.

CONCLUSIONS

Findings suggest that a subset of mental health symptoms have shared negative affective dynamics patterns. Longitudinal research is needed to rigorously examine the directionality of the effects underlying the association between affective dynamics and mental health issues.

Mood variability during adolescent development and its relation to sleep and brain development

Mood swings, or mood variability, are associated with negative mental health outcomes. Since adolescence is a time when mood disorder onset peaks, mood variability during this time is of significant interest. Understanding biological factors that might be associated with mood variability, such as sleep and structural brain development, could elucidate the mechanisms underlying mood and anxiety disorders. Data from the longitudinal Leiden self-concept study (N = 191) over 5 yearly timepoints was used to study the association between sleep, brain structure, and mood variability in healthy adolescents aged 11-21 at baseline in this pre-registered study. Sleep was measured both objectively, using actigraphy, as well as subjectively, using a daily diary self-report. Negative mood variability was defined as day-to-day negative mood swings over a period of 5 days after an MRI scan. It was found that negative mood variability peaked in mid-adolescence in females while it linearly increased in males, and average negative mood showed a similar pattern. Sleep duration (subjective and objective) generally decreased throughout adolescence, with a larger decrease in males. Mood variability was not associated with sleep, but average negative mood was associated with lower self-reported energy. In addition, higher thickness in the dorsolateral prefrontal cortex (dlPFC) compared to same-age peers, suggesting a delayed thinning process, was associated with higher negative mood variability in early and mid-adolescence. Together, this study provides an insight into the development of mood variability and its association with brain structure.

The role of self-referential and social processing in the relationship between pubertal status and difficulties in mental health and emotion regulation in adolescent girls in the UK

Adolescence is marked by the onset of puberty, which is associated with an increase in mental health difficulties, particularly in girls. Social and self-referential processes also develop during this period: adolescents become more aware of others' perspectives, and judgements about themselves become less favourable. In the current study, data from 119 girls (from London, UK) aged 9-16 years were collected at two-time points (between 2019 and 2021) to investigate the relationship between puberty and difficulties in mental health and emotion regulation, as well as the role of self-referential and social processing in this relationship. Structural equation modelling showed that advanced pubertal status predicted greater mental health and emotion regulation difficulties, including depression and anxiety, rumination and overall difficulties in emotion regulation, and in mental health and behaviour. Advanced pubertal status also predicted greater perspective-taking abilities and negative self-schemas. Exploratory analyses showed that negative self-schemas mediated the relationships between puberty and rumination, overall emotion regulation difficulties, and depression (although these effects were small and would not survive correction for multiple comparisons). The results suggest that advanced pubertal status is associated with higher mental health and emotion regulation problems during adolescence and that negative self-schemas may play a role in this association. RESEARCH HIGHLIGHTS: This study investigates the relationship between puberty, mental health, emotion regulation difficulties, and social and self-referential processing in girls aged 9-16 years. Advanced pubertal status was associated with worse mental health and greater emotion regulation difficulties, better perspective-taking abilities and negative self-schemas. Negative self-schemas may play a role in the relationships between advanced pubertal status and depression, and advanced pubertal status and emotion regulation difficulties, including rumination.

Experience-dependent neurodevelopment of self-regulation in adolescence

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

Excitatory and inhibitory neurochemical markers of anxiety in young females

Between the ages of 10-25 years the maturing brain is sensitive to a multitude of changes, including neurochemical variations in metabolites. Of the different metabolites, gamma-aminobutyric acid (GABA) has long been linked neurobiologically to anxiety symptomology, which begins to manifest in adolescence. To prevent persistent anxiety difficulties into adulthood, we need to understand the maturational trajectories of neurochemicals and how these relate to anxiety levels during this sensitive period. We used magnetic resonance spectroscopy in a sample of younger (aged 10-11) and older (aged 18-25) females to estimate GABA and glutamate levels in brain regions linked to emotion regulation processing, as well as a conceptually distinct control region. Within the Bayesian framework, we found that GABA increased and glutamate decreased with age, negative associations between anxiety and glutamate and GABA ratios in the dorsolateral prefrontal cortex, and a positive relationship of GABA with anxiety levels. The results support the neural over-inhibition hypothesis of anxiety based on GABAergic activity.

Interactions among stress, behavioral inhibition, and delta-beta coupling predict adolescent anxiety during the COVID-19 pandemic

The COVID-19 pandemic brought about unprecedented changes and uncertainty to the daily lives of youth. The range of adjustment in light of a near-universal experience of COVID restrictions highlights the importance of identifying factors that may render some individuals more susceptible to heightened levels of anxiety during stressful life events than others. Two risk factors to consider are temperamental behavioral inhibition (BI) and difficulties in emotion regulation (ER). As such, the current paper focused on BI examined prior to COVID, because of its developmental link to anxiety and ER, as difficulties may be associated with differences in anxiety. We examined a neurocognitive marker of ER processes, delta-beta coupling (DBC). The current paper had two goals: (1) to examine BI in relation to COVID-related worry and social anxiety experienced during the pandemic, and (2) to explore the role of individual differences in early DBC in the relationship between BI and anxiety outcomes 6 months apart during COVID-19 (n = 86; T1 Mage  = 15.95, SD = 1.73; T6 Mage  = 16.43, SD = 1.73). We found support for the moderating role of DBC in the relationship between BI levels and social anxiety disorder (SAD) symptom severity during the pandemic. Here, high BI was predictive of increased SAD symptom levels in adolescents with stronger DBC.