'Too many BeEPs in our teens!' Behavioral and emotional problems in a large group of Italian adolescents

Role of attachment style in the association between childhood adversities and non-suicidal self-injury among young adults: a multigroup structural equation study

Background

Non-suicidal self-injury (NSSI) is a significant health concern among adolescents and young adults, often resulting from adverse childhood experiences (ACEs). Dissociation, post-traumatic symptoms and attachment style may have a role in shaping such associations.

Aims

This study aims to provide a unified model of the impact of ACEs on NSSI, exploring complex post-traumatic stress disorder (cPTSD) symptoms and dissociation as potential mediators and the role of the predominant attachment style in affecting such associations.

Methods

1010 young individuals attending the last year of high school participated in this cross-sectional study. ACEs, cPTSD, dissociation and NSSI were evaluated using self-report questionnaires. We fitted a path model of NSSI, with ACEs as exogenous variables and cPTSD and dissociation as sequential mediators. Secure, fearful and preoccupied attachment styles were modelled as grouping variables.

Results

Our findings showed that dissociation mediated the impact of ACEs on NSSI in subjects with a fearful attachment style, as opposed to those with a preoccupied attachment for whom cPTSD symptoms mediated the ACEs-NSSI association.

Conclusions

Attachment styles moderate the relationship between ACEs and NSSI, with either dissociation or post-traumatic symptomatology mediating the impact of ACEs on NSSI, depending on the predominant attachment style. Our results highlight the importance of attachment as a pathway modifier in the relationships between different psychopathology dimensions, providing a useful framework to better conceptualise the ACEs-NSSI association.

Youth Epidemiology and Resilience (YEAR) in a student population: prevalence and predictors of mental health symptoms

Background

Adolescence is a pivotal developmental phase, marked by a high prevalence of mental health issues. The Singapore Youth Epidemiology and Resilience (YEAR) study aims to assess the prevalence of mental health symptoms, sociodemographic risk factors, and the protective role of resilience in a multi-ethnic, Asian school-going adolescent population.

Methods

School-based adolescents aged 11-18 and their parents were invited from a stratified sample of national schools, designed to be demographically representative of the mainstream school-going population. In the screening phase, adolescents completed a battery of questionnaires including the Youth Self-Report (YSR), Child Behaviour Checklist (CBCL), and the Singapore Youth Resilience Scale (SYRESS). Thereafter, diagnostic interviews were conducted on high-risk and control participants. Data analysis was conducted to establish prevalence rates of mental health symptoms, and to examine the associations between mental health symptoms, sociodemographic factors, and resilience.

Results

The final study sample consisted of 3336 adolescents and 2475 parents. Based on adolescents' response on the YSR, 37.3%, 13.1% and 27.7% of the YEAR Study population scored in the clinical range for internalizing, externalizing and total problems respectively. Based on parents' reporting on their children on the CBCL, 15.9%, 4.0% and 11.2% scored in the clinical range for internalizing, externalizing and total problems respectively. Sociodemographic risk factors for specific mental health symptoms were identified, including belonging to the age category of 15-16 (OR, 1.8-2.2) and those living in either a 4-, 5-room or executive flat (OR, 0.6-0.7), or in condominiums and other apartments (OR, 0.4-0.6). Total resilience scores were moderately correlated with total [rs(3334) = -.49, p <.01] and internalizing [rs(3334) = -.50, p <.01] problem scores on the YSR.

Conclusion

This study illustrates the state of mental health of school-going adolescents aged 11-18. The greater prevalence of internalizing symptoms indicates the need for stronger attention for identifying internalizing problems and targeted interventions for those at risk of such symptoms. The association between mental health symptoms and resilience factors highlights the protective potential of resilience building for adolescents.

Investigating associations between emotional and behavioral problems, self-esteem, and parental attachment among adolescents: A cross-sectional study in Indonesia

Background

Emotional and Behavioral Problems (EBPs) are prevalent among adolescents, and adolescents' capacity for adaptation can be influenced by their interactions with their parents, environment, and self-esteem. This link has not been systematically examined among adolescents in West Sumatra, Indonesia. This study aimed to assess the association of parental attachment and self-esteem with EBPs in adolescents.

Methods

A cross-sectional study was conducted from July to November 2022 in Padang West Sumatra, Indonesia. In total, 854 students from public senior high school 4 Padang were involved in this study and completed questionnaires on demographics, EBPs, parental attachment, and self-esteem. There was a total of five subscales for EBPs, which included emotional problems, conduct problems, hyperactivity, peer problems and prosocial. Additionally, there were three subscales for parental attachment, which included the mother's attachment, father's attachment, and peer attachment. Spearman's correlation, independent-sample t-tests, ANOVA and multiple linear regression analysis were employed to examine factors associated with EBPs.

Results

This study showed that father's attachment (r = -0.191, p < 0.001), mother's attachment (r = -0.241, p < 0.001), and self-esteem (r = -0.437, p < 0.001) were negatively correlated with EBPs. The linear regression analysis showed EBPs was associated with father's education, father's communication, father's alienation, mother's alienation, and self-esteem. All predictors of overall EBPs among adolescents were able to explain 31 % of the variance in EBPs.

Conclusion

High self-esteem and a strong parental attachment have positive outcomes in terms of mental health in adolescents. Thus, increasing adolescent self-esteem and establishing a warm parent attachment can be the main target in providing interventions for Indonesian adolescents with EBPs.

Daring and Distress: Insights on Adolescent Risk Taking and Difficulties in Emotion Regulation from a Network Analysis Perspective

We explored the interrelationships between risk-taking and self-harm in typically developing adolescents by examining various contributing factors, such as personality traits, difficulties in emotion regulation, attachment styles, and maladaptive psychological functioning. A sample of 234 Italian adolescents completed the Risk-Taking and Self-Harm Inventory for Adolescents (RTSHIA), the Risk-Taking Questionnaire (RT-18), the Difficulties in Emotion Regulation Strategies (DERS), the State Adult Attachment Measure (SAAM), and the Youth Self-Report (YSR). Network analysis was used to visualize and describe the interdependencies among the variables. Risk-taking behaviors were strongly linked to rule-breaking, aggression, and risk propensity, while self-harm behaviors were connected to limited access to emotion regulation strategies and thought problems. Centrality indices indicated that variables such as anxiety/depression, limited access to emotion regulation strategies, and rule-breaking had a high influence within the network. This study provided a comprehensive understanding of the nomological network of risk-taking and self-harm behaviors among adolescents. It highlighted the relative importance of factors such as emotion regulation difficulties and maladaptive psychological functioning in influencing these behaviors. The findings could inform psychological interventions and prevention strategies targeting adolescents at risk for engaging in risk-taking or self-harm behaviors.

Deliberative and Affective Risky Decisions in Teenagers: Different Associations with Maladaptive Psychological Functioning and Difficulties in Emotion Regulation?

Using network analysis, we investigated the relationships between maladaptive psychological functioning, difficulties in emotion regulation, and risk-taking in deliberative and affective behavioral decisions. Participants (103 adolescents aged between 13 and 19 years, 62% boys) took the Cold (deliberative) and Hot (affective) versions of the Columbia Card Task and completed the Youth Self-Report (YSR) and the Difficulties in Emotion Regulation Scale (DERS). In contrast to the view that risk propensity increases from preadolescence to middle adolescence and decreases at later ages, our study revealed no age-specific trend. YSR syndrome scales were significantly correlated with risk propensity, but only in the Cold version. The YSR Thought Problems scale was the most central node in the network, linking internalizing and externalizing problems with risk propensity in the Cold CCT. Lack of emotional Clarity was the only DERS consistently linked with risk-taking both in correlation and network analyses. Maladaptive psychological functioning and difficulties in emotion regulation were linked with risk propensity in affective risky decisions through deliberative processes. The statistical significance of direct and indirect effects was further examined using nonparametric mediation analyses. Our study highlights the role of cognitive factors that in each variable set might account for risk-taking in teenagers.