General psychopathology and its social correlates in the daily lives of youth

COVID-19-Related Changes in Adolescents' Daily-Life Social Interactions and Psychopathology Symptoms

ABSTRACT

The COVID-19 pandemic is believed to have strongly impacted adolescents' mental health through limiting their day-to-day social lives. However, little is known about the role of (social) risk/protective factors and adolescent mental health. Subclinical psychopathology, and risk and protective factors of n = 173 adolescents (T1 mean age = 16.0; 89% girls) were assessed prepandemic and early-pandemic (T1: 2018/2019; T2: May 2020). Daily-life social interactions were assessed in 6-day experience sampling periods. Correcting for age, multilevel analyses revealed declines in general psychopathology and anxiety symptoms; fewer face-to-face social interactions, more online social interactions; and higher-quality face-to-face interactions during the pandemic than before. Negative associations between psychopathology and the quality of face-to-face peer and family interactions were stronger during the pandemic than prepandemic. The results reflect that, early in the pandemic, the mental health impact on adolescents may have been limited. High-quality face-to-face interactions with family and peers seemed particularly powerful in keeping adolescents resilient.

Which personal and social resources help adolescents to recover from negative affect in daily life? An experience sampling study

Background: Reducing anxiety and depression in adolescents is a global health priority. Personal and social resources (e.g., hobbies and socialising) may reduce distress. Yet, there is insufficient understanding of how adolescents use such resources to reduce distress.Objective: To identify resources that reduced distress in the everyday lives of adolescents and whether resource use differed according to symptoms of anxiety and depression.Methods: The experience sampling method was used, a longitudinal method requiring participants to report on context and mood at randomly selected moments across a week. A total of 5 558 reports were contributed by 151 adolescents, including 90 with symptoms of anxiety and/or depression. The study was conducted in the poorest neighbourhoods of Bogotá, Buenos Aires, and Lima.Results: Multi-level modelling indicated that using resources was significantly associated with less nervousness and sadness. Adolescents with symptoms of anxiety and/or depression were less likely to use some resources (e.g., sport). Cross-level interactions showed the efficacy of resources differed according to the severity of symptomatology. For adolescents with symptoms of anxiety and depression, some resources (e.g., peer support) improved mood, while others (e.g., music listening) did not.Discussion: Personal and social resources are important for reducing distress in the everyday life of adolescents, giving insight into potential interventions to help mitigate symptoms of anxiety and depression before escalation. Further research could assess the quality of experiences (e.g., appraisal) to deepen understanding of how engagement promotes resilience.Conclusions: Care must be taken when recommending resource use, since some forms (e.g., music listening) may be unhelpful to adolescents with symptoms of anxiety and depression.

Social processes as the missing link: cross-sectionally testing a conceptual model on social mediators of early psychopathological development

BACKGROUND

Research suggests that most mental health conditions have their onset in the critically social period of adolescence. Yet, we lack understanding of the potential social processes underlying early psychopathological development. We propose a conceptual model where daily-life social interactions and social skills form an intermediate link between known risk and protective factors (adverse childhood experiences, bullying, social support, maladaptive parenting) and psychopathology in adolescents - that is explored using cross-sectional data.

METHODS

N = 1913 Flemish adolescent participants (Mean age = 13.8; 63% girls) were assessed as part of the SIGMA study, a large-scale, accelerated longitudinal study of adolescent mental health and development. Self-report questionnaires (on risk/protective factors, social skills, and psychopathology) were completed during class time; daily-life social interactions were measured during a subsequent six-day experience-sampling period.

RESULTS

Registered uncorrected multilevel linear regression results revealed significant associations between all risk/protective factors and psychopathology, between all risk/protective factors and social processes, and between all social processes and psychopathology. Social processes (social skills, quantity/quality of daily social interactions) were uniquely predicted by each risk/protective factor and were uniquely associated with both general and specific types of psychopathology. For older participants, some relationships between social processes and psychopathology were stronger.

CONCLUSIONS

Unique associations between risk/protective factors and psychopathology signify the distinct relevance of these factors for youth mental health, whereas the broad associations with social processes support these processes as broad correlates. Results align with the idea of a social pathway toward early psychopathology, although follow-up longitudinal research is required to verify any mediation effect.

A Multi-Method Approach for the Identification of Social Functioning Profiles in Autistic Adolescents and Young Adults Without Intellectual Disability

Given the diverse nature of the autism spectrum and the complex, context-dependent nature of Social Functioning (SF), this study aims to delineate profiles of SF in young people with autism. Using a multi-method approach, it aims to gain a comprehensive understanding of social difficulties in people with ASD. This study also examines the co-occurrence of mental health issues within these profiles, which can exacerbate social impairments. This understanding is essential for designing interventions and support systems tailored to the specific needs of people with ASD. 49 autistic individuals aged 12 to 30, without intellectual disability were recruited. A combination of measures was used to thoroughly assess SF. Latent profile analysis was employed to identify distinct profiles of social functioning. A control group of 60 non-autistic people served as a reference for these profiles. Mental health difficulties were evaluated through clinical interviews and questionnaires. Two profiles of SF were identified, illustrating two ways of managing the cost of social interactions. Compared to controls, one was more socially withdrawn, spending more time alone, while the other spent a similar amount of time alone but interacted less with others. A different prevalence of mental health problems was observed within these profiles. This study highlighted two SF profiles in young people with ASD, revealing different approaches to managing social interactions. These results show that people with ASD do not have uniform strengths and difficulties of SF, and that mental health problems exert a significant influence on different aspects of SF.

Sex Differences in Subclinical Psychotic Experiences: The Role of Daily-Life Social Interactions

BACKGROUND AND HYPOTHESIS

Sex differences in psychosis are reported across the psychosis spectrum, including in subclinical stages. An important factor in understanding these variations is the subjective experience of everyday social interactions (SI). We investigated whether the presence of psychotic experiences (PEs), as well as associated distress, differs between men and women. We focused on the role of daily-life SI quality and whether its association with PEs varies by sex.

STUDY DESIGN

We included adolescents from SIGMA, a general youth population study in Flanders, Belgium (n = 344; mean age = 18.7; 63.4% female). Psychotic experiences were measured using the PQ-16. We used Experience Sampling Methodology to assess daily-life SI. A multilevel model and multiple linear regressions were used to assess, respectively, the relationship between sex and SI quality and whether PEs and their association with SI quality differ between young men and women.

STUDY RESULTS

The results of the multilevel linear regression model indicate that the prevalence of and distress associated with PEs were higher in women. No significant difference was observed in the subjective quality of daily SI. Social interaction quality was strongly related to PEs. This association did not seem to vary for the prevalence of PEs, though women's distress about PEs appeared to be more affected by SI quality.

CONCLUSIONS

Present findings highlight the role of the subjective quality of SI in subclinical psychosis. More research is needed to investigate the mechanisms through which SI quality relates to PEs, and whether these differ between young men and women.

Unravelling the Longitudinal Relations Between Developmental Milestones, General Psychopathology, and Personality Functioning in a Youth Clinical Sample

Personality functioning, general psychopathology, and developmental milestones achievement are critical domains in the field of young people's mental health; however, no prior research has considered these variables jointly or examined the temporal dynamics between them. To fill these gaps, the present study aimed to investigate the longitudinal associations between the above constructs in a clinical sample of Dutch youth. 525 outpatients (72.5% women; age range: 12-26 years, M = 18.8 ± 2.83) diagnosed with different psychological difficulties were recruited from specialized mental health care services in The Netherlands. They completed self-report measures assessing personality functioning, psychopathological symptoms, and the achievement of youth-specific developmental milestones. Data were collected on three occasions within a year and modelled using a Cross-Lagged Panel Model approach. The levels of personality dysfunction, general psychopathology, and developmental milestones achievement were found to fluctuate from one wave to the other. Personality dysfunction and general psychopathology were positively interrelated at each time point, while both constructs were negatively associated with developmental milestones achievement. Importantly, difficulties achieving developmental milestones predicted a worsening in personality functioning 6 months later. This result would suggest that the achievement of developmental milestones precedes personality functioning, supporting the importance of interventions promoting age-adequate functioning in youth.

The experience sampling methodology in psychosis risk states: A systematic review

The experience sampling method (ESM) is a structured diary technique, which is used to assess thoughts, mood and appraise subjective experiences in daily life. It has been recognized as a useful tool for understanding the characteristics, dynamics, and underlying mechanisms of prodromal symptoms of psychosis. The present systematic review aimed to provide a qualitative synthesis of findings provided by the ESM studies conducted in people with psychosis risk states. A systematic review of the MEDLINE, ERIC, Academic Search Ultimate, and Health Source: Nursing/Academic Edition databases, utilizing search terms related to the ESM and the risk of psychosis was conducted. Out of 1069 publication records identified, 77 studies met the inclusion criteria for the review. Data were synthesized around the following topics: 1) assessment of symptoms dynamics and social functioning; 2) assessment of the mechanisms contributing to the emergence of psychotic experiences and 3) assessment of stress sensitivity. The studies have shown that negative emotions are associated with subsequent development of paranoia. The tendency to draw hasty conclusions, aberrant salience, self-esteem, and emotion regulation were the most frequently reported mechanisms associated with the emergence of psychotic experiences. Studies using the ESM also provided evidence for the role of stress sensitivity, in the development of psychotic symptoms. The ESM has widely been applied to studies investigating psychosis risk states, using a variety of protocols. Findings from this systematic review might inform future studies and indicate potential targets for interventions.

Considering the 'With Whom': Differences Between Event- and Signal-Contingent ESM Data of Person-Specific Social Interactions

Experience sampling studies often aim to capture social interactions. A central methodological question in such studies is whether to use event- or signal-contingent sampling. The little existing research on this issue has not taken into account that social interactions occur with unique interaction partners (e.g., Anna or Tom). We analyze one week of social interaction data of 286 students from the University of Pittsburgh (60.8% male, mean age 19.2 years), taking into account the unique interaction partners of each student. Specifically, we investigate the differences between event- and signal contingent sampling in (1) the total number of unique interaction partners captured, as well as (2) the kinds of relationships, and (3) the quality of social interactions with these captured interaction partners. Apart from a larger quantity of interactions and unique interaction partners in the event-contingent sampling design, our analyses indicate subtle differences between the two designs when aiming to assess social interactions with more distant interaction partners, such as coworkers or strangers. Most importantly, in our analyses, specific interaction partners and social roles explained a considerable amount of variance in the quality of social interactions (up to 20.5%), suggesting that future research would benefit greatly from considering "with whom" individuals interact.

Initial validation of the Multidimensional Adolescent Functioning Scale (MAFS) in Spanish-speaking students from Chilean secondary schools

INTRODUCTION

Psychosocial functioning is closely associated with psychopathology and wellbeing in different populations, particularly adolescents. Despite its relevance, measures assessing psychosocial functioning in healthy adolescents are scant as most focus on adults or clinical populations. We evaluated the psychometric properties of the Multidimensional Adolescent Functioning Scale (MAFS), a self-report questionnaire created to assess three dimensions of psychosocial functioning ('general functioning', 'family-related functioning', and 'peer-related functioning') in adolescents from the general population.

METHODS

After translation and cultural adaptation, we administered the Spanish MAFS to 619 adolescents aged 14 to 19. We assessed the factor structure, internal consistency, and associations with depressive symptoms, suicidal ideation, cognitive-behavioral skills, cognitive reappraisal (CR), and expressive suppression (ES). We additionally tested for measurement invariance based on biological sex.

RESULTS

The original three-factor structure showed the best fit. Internal consistency was good for the total scale (ω = 0.874; α = 0.869; GLB = 0.939, r_M=0.216) and for all subscales (ω = 0.806-0.839; α = 0.769 to 0.812; GLB = 0.861-0.873). Correlations between all three MAFS subscales were significant, ranging between 0.291 and 0.554. All MAFS subscales correlated positively and significantly with cognitive-behavioral skills and adaptive regulatory strategies and negatively with depressive symptoms and suicidal ideation.

CONCLUSION

The Spanish MAFS translation is a valid and reliable self-report measure to assess three domains of psychosocial functioning in adolescents aged 14-19 from the general population.

mHealth in psychiatry: A pathway to person-centered care

Influenced by the field of epidemiology and the early ecological psychologists, my research focused on the role of person-environment interactions in the development and maintenance of psychopathology - a field I would name Contextual Psychiatry. To capture the interaction between the person and the environment, I was one of the early adopters of the Experience Sampling Method (ESM) in mental health research. Using ESM, we demonstrated that there is an affective pathway to psychosis, characterized by increased stress-reactivity. Also altered social interactions have been identified as an important factor in the development of psychopathology. With digital technology quickly evolving, the impact of my work has now been extended to the development and implementation of mHealth and digital Health approaches in mental health, including the clinical application of ESM in routine mental health care as well as the development of Ecological Momentary Interventions. Moving forward, if we want to deliver treatment at moments when it is most needed and adapted to the needs of the individual, we need to advance our understanding of the real-time dynamics of the psychological and physiological processes of psychopathology - thus establishing a more personalised mental health care.

Impact of smartphone overuse on 1-year severe depressive symptoms and momentary negative affect: Longitudinal and experience sampling findings from a representative epidemiological youth sample in Hong Kong

Smartphone overuse can have detrimental impacts on youth mental health. How it may be longitudinally associated with depressive symptoms and functioning, and with daily momentary affect, remains to be investigated. A total of 3,033 young people were consecutively recruited from a large-scale epidemiological youth mental health study in Hong Kong. A subsample (n = 936) was followed-up after 1 year, with experience sampling data collected from 177 participants. Separate multivariable logistic regression models were applied to examine the prospective associations between smartphone overuse and depressive symptoms, with multilevel models fitted to examine its associations with momentary affect. The prevalence of smartphone overuse in the Hong Kong youth population was 29.3%. Smartphone overuse was significantly associated with more depressive symptoms and functional impairments both cross-sectionally and longitudinally. The associations between smartphone overuse and 1-year depressive symptoms were significant, even when accounting for baseline symptoms, social media use, and other risk and protective factors. Baseline depressive symptoms, in contrast, were not associated with 1-year smartphone overuse after adjusting for baseline smartphone overuse. Smartphone overuse was also significantly associated with higher levels of momentary negative affect, even when accounting for depressive symptoms. Strategies to mitigate the impact of smartphone overuse can have important long-term implications.