Risk and protective factors associated with trajectories of depressed mood from adolescence to early adulthood

Gender gap in tooth brushing among Korean adolescents

BACKGROUND

Previous studies have reported a gender gap in toothbrushing habits. Before the COVID-19 pandemic, the prevalence of tooth brushing after lunch among South Korean schoolboys (29.2%) was approximately half of that among girls (48.5%). During the pandemic, the rate of tooth brushing decreased in both boys and girls. However, the gender gap in toothbrushing decreased by 5.6%, owing to a larger decline in girls. This study aimed to understand the gender gap in toothbrushing before and during the pandemic.

MATERIALS AND METHODS

Based on analyses of data obtained from the Korea Youth Risk Behavior Web-based Survey from 2017 to 2022, the nationally representative sample (n = 341,265) comprised middle and high school students. Chi-square tests and weighted probit regressions were performed to evaluate differences in the prevalence of tooth brushing after lunch according to socioeconomic factors, health-related behaviors, and mental health conditions. All analyses were performed using Stata (version 18.0, Stata Corp, College Station, Texas, USA), and statistical significance was set to α = 0.05.

RESULTS

The gender gap cannot be explained by differences in hygiene practices (e.g., handwashing), health behaviors (smoking), parental education, family socioeconomic circumstances, depressive symptoms, or stress. One reason for the decline may be the policy of mandatory mask-wearing in Korean schools during the pandemic.

CONCLUSIONS

If girls were more motivated than boys to brush their teeth for cosmetic reasons (clean appearance of teeth or fresh breath), this may account for the larger decrease in tooth brushing among girls during the mandatory mask-wearing policy.

Disabilities and depression in young adolescents living in underdeveloped areas of Indonesia: results from the 2018 Indonesia Basic Health Survey

OBJECTIVES

This study aimed to investigate the association between the type and severity of disabilities and depression among adolescents aged 15-17 years living in underdeveloped areas of Indonesia.

DESIGN

Cross-sectional study.

SETTING

Data were derived from the 2018 Indonesia Basic Health Research, a nationally representative data of Indonesia.

PARTICIPANT

We used information collected from 4811 adolescents aged 15-17 living in underdeveloped areas of Indonesia.

PRIMARY OUTCOME

The primary outcome was depression, based on the conditions experienced by respondents during the last 2 weeks.

RESULTS

The analysis showed that 5.65% of adolescents aged 15-17 years living in underdeveloped areas of Indonesia had depressive symptoms. Adolescents with severe physical and psychological disabilities were most at risk, exhibiting significantly higher odds of developing depression (aOR=12.09, 95% CI: 5.41 to 27.03, p<0.001). Other significant predictors included female adolescents (aOR=2.18, 95% CI: 1.51 to 3.14, p<0.001) and those who had a non-communicable disease (aOR=3.50, 95% CI: 1.00 to 12.18, p=0.049).

CONCLUSIONS

These findings highlight the critical need for targeted depression interventions and collaborative efforts to support vulnerable adolescents in underdeveloped areas of Indonesia, particularly those with disabilities, girls and those with non-communicable diseases. Efforts to engage healthcare providers, educators and policymakers to improve access to mental health resources will enhance the overall well-being of vulnerable populations.

Network temperature as a metric of stability in depression symptoms across adolescence

Depression is characterized by diverse symptom combinations that can be represented as dynamic networks. While previous research has focused on central symptoms for targeted interventions, less attention has been given to whole-network properties. Here we show that 'network temperature', a novel measure of psychological network stability, captures symptom alignment across adolescence-a critical period for depression onset. Network temperature reflects system stability, with higher values indicating less symptom alignment and greater variability. In three large longitudinal adolescent cohorts (total N = 35,901), we found that network temperature decreases across adolescence, with the steepest decline during early adolescence, particularly in males. This suggests that depression symptom networks stabilize throughout development via increased symptom alignment, potentially explaining why adolescence is a crucial period for depression onset. These findings highlight early adolescence as a key intervention window and underscore the importance of sex-specific and personalized interventions.

The More, the Better? Social Capital Profiles and Adolescent Internalizing Symptoms: A Latent Profile Analysis

Past research suggests that offline and online social capital are empirically linked to adolescent psychological adjustment. However, little is known regarding the implications of distinctive combinations of social capital for adolescent internalizing symptoms. The present study aimed to examine adolescent social capital patterns and their associations with internalizing symptoms by using latent profile analysis. A cross-sectional web-based survey was conducted among 1595 Chinese adolescents (mean age = 14.30 years, 50.7% male). All adolescents completed self-report questionnaires on their perceived offline and online social capital, depressive symptoms and anxiety symptoms. Latent profile analysis revealed four profiles of social capital: (1) Low Social Capital, (2) Moderate Social Capital, (3) High Social Capital, and (4) Only High Offline Social Capital. Further, analysis of covariance demonstrated that the Only High Offline Social Capital profile had significantly fewer internalizing symptoms than other three profiles. No statistical differences of internalizing symptoms were found between the other three profiles, except that the Moderate Social Capital profile showed fewer anxiety symptoms than the Low Social Capital profile. These findings suggest that more social capital does not equal to better mental health status. The social capital profiles and their associations with adolescent internalizing symptoms may provide practitioners with meaningful implications regarding the role of offline and online social capital in adolescent psychological adjustment.

Age-Dependent Relationship between Self-Esteem and Depressive Symptoms in Korean Adolescents: a Meta-Analysis of Longitudinal Studies

Self-esteem is a powerful protective factor against depressive symptoms, with cognitive vulnerability theory suggesting that early self-esteem more strongly predicts later depressive symptoms than vice versa. While some meta-analyses have examined these relationships, limited knowledge exists on the prospective relationship between self-esteem and depressive symptoms, particularly how it changes with age. This study conducted a longitudinal meta-analysis of nine studies (20,733 participants) on the prospective relationship between self-esteem and depressive symptoms in Korean children and adolescents. Relationships were analyzed by integrating the effect sizes of 22 zero-order correlations and 17 partial correlations and examining age-related changes. The results indicated significant negative correlations in both zero-order and partial correlations. Age-related changes showed a reverse U-shape trend in partial correlations, with the strongest negative association during childhood, weakening until age 14, and then strengthening again. Moderator analysis revealed no significant effect size variation based on publication type or gender proportion, but more recent birth cohorts exhibited a stronger negative relationship in zero-order correlations. Significant differences were also found based on the measurement instrument of depressive symptoms. These findings highlight the importance of tailored interventions to enhance self-esteem and mitigate depressive symptoms, extending the cognitive vulnerability model within Korea's cultural context and providing insights into Korean youth mental health.

Prediction of late-onset depression in the elderly Korean population using machine learning algorithms

Late-onset depression (LOD) refers to depression that newly appears in elderly individuals without prior depression episodes. Predicting future depression is crucial for mitigating the risk of major depression in prospective patients. This study aims to develop machine learning models to predict future depression. Using public data from the nationwide panel survey 'Korean Longitudinal Study of Aging,' we employed latent growth modeling and growth mixture modeling to identify four latent classes of depression trajectories in the elderly Korean population. Based on the results of binary logistic regression, we selected 12 variables capable of distinguishing the LOD population from the reference population and tested 12 machine learning (ML) algorithms. While most ML algorithms showed acceptable predictive capability, Random Forest Classifier and Gradient Boosting Classifier demonstrated superior performance. Consequently, we successfully established new ML-based LOD prediction programs. These programs could be further developed into self-checking online tools, expected to serve as decision support systems for primary medical care and health screening services.

Association between depressive symptom trajectories and unhealthy lifestyle factors among adolescents based on the China family panel studies

BACKGROUND

The prevalence of depressive symptom in adolescents has sharply increased over the past decade. Depressive symptom during adolescence could hinder the development of social, cognitive, and psychological competencies, potentially influencing young adults' lifestyle factors. This study aimed to identify trajectories of depressive symptom from adolescence to early adulthood and evaluated their association with lifestyle factors in early adulthood.

METHODS

Data was collected from the China Family Panel Studies (CFPS). The Center for Epidemiological Studies Depression Scale (CES-D) was assessed during the 2016, 2018, and 2020. Group - based trajectory modeling was used to identify trajectories of depressive symptom over a 5 - year follow - up. We used binary logistic regression analyze to explore the relationship between depressive symptom trajectories and lifestyle factors.

RESULTS

We identified four trajectories of depressive symptom, characterized by maintained low scores (non - symptom); moderately high scores (moderately high symptom); consistently high scores (persistently high symptom); and low starting scores that steadily increased (increasing symptom). After adjusting for potential confounding factors, the ORs for smoking were 2.95 (1.47, 5.97) for the "persistently high symptom" trajectory comparing to the "non - symptom" trajectory.

CONCLUSION

The depressive symptom trajectories was associated with unhealthy lifestyle factors. Future studies are needed to determine whether depressive symptom might serve as early indicators prompting adolescents to make psychological changes that could reduce the risk of unhealthy lifestyle factors in the later life.

Achievement Goals as Mediators of the Links Between Self-Esteem and Depressive Symptoms From Mid-Adolescence to Early Adulthood

Numerous studies have sought to determine whether low self-esteem acts as a risk factor for depressive symptoms (i.e., a vulnerability model) or whether depressive symptoms lead to a decrease in self-esteem (i.e., a scar model). Although both models have received some support, very little research has: (a) addressed this question across critical life transitions likely to modify this pattern of associations, such as the transition to adulthood; (b) sought to identify the psychological mechanisms (i.e., mediators) underpinning these associations. The present study was designed to address these two limitations, focusing on the directionality of the associations between depressive symptoms and self-esteem from mid-adolescence to early adulthood while considering the role of motivational factors, namely mastery (intrinsic/extrinsic) and performance (approach/avoidance) goals as conceptualized in achievement goal theory. A sample of 707 Finnish adolescents aged 15-16 (52.1% boys) was surveyed six times up to the age of 25. Results from a cross-lagged panel model (CLPM) revealed that depressed individuals were more likely to have low self-esteem, although self-esteem protected against depressive symptoms between ages 16-17 to 20-21. Moreover, while self-esteem promoted mastery-extrinsic goals which in turn reinforced self-esteem, depressive symptoms promoted performance-avoidance goals which led to more depressive symptoms and lower self-esteem. Overall, these findings highlight (1) the long-lasting negative consequences of depressive symptoms on self-esteem and (2) the crucial role played by academic motivation in explaining the development of depressive symptoms and self-esteem over time. In turn, these results help refine the vulnerability and scar models, and suggest that motivational factors should be considered in prevention and intervention efforts among young populations.

Trend and predictive psychosocial factors of persistent depression/non-depression in Chinese adolescents: A three-year longitudinal study

BACKGROUND

Depressive symptoms are common in adolescents, while its prevalence trend in adolescents is seldom reported. In addition, few studies focus on adolescents without depressive symptoms. This study aimed to reveal the trend and predictors of persistent depression/non-depression among Chinese adolescents over three-year period.

METHODS

Three-wave data were collected from T1 to T3 in a sample from six junior high schools in Shenzhen, China. The 20-item of Center for Epidemiologic Studies Depression Scale was used, with scoring ≥16 as depression.

RESULTS

Of all 1301 adolescents, 33.4%, 15.5% and 9.0% reported depressive symptoms at baseline, T2 and T3 respectively, while 66.6%, 47.7% and 39.6% reported non-depressive symptoms at three time-points. At the individual level, baseline positive identity and general positive youth development significantly increased persistent non-depression at T2 and T3. At the family level, baseline family harmony and communication consistently prevented persistent depression at T2 and T3, while family communication consistently promoted non-depression. At the school level, baseline awareness of no expectation from teacher and poor interpersonal relationship consistently increased persistent depression and prevented non-depression.

CONCLUSIONS

The incidence of depression in adolescents aged 11-15 is not high. The rate of persistent non-depression is approximately 30% higher than that of persistent depression, and both have a downward trend over years. Positive youth development and healthy family function are protective factors of depression, while school maladjustment decreases persistent non-depression. During early adolescence, more attention should be paid to family function and school maladjustment to promote non-depression in adolescents from a new broader view.

Association between parental educational involvement and adolescent depressive symptoms: a systematic review and meta-analysis

BACKGROUND

Adolescents in their school-age period undergo rapid changes in various aspects, such as physiological development, academic pressure, and interpersonal relationships, constitute a high-risk group for depression. Parental educational involvement, as a critical family variable, influences not only children's academic achievement but also their psychological well-being. However, previous research has shown significant discrepancies regarding the relationship between parental educational involvement and adolescent depressive symptoms.

METHODS

To elucidate the overall strength of the association between parental educational involvement and adolescent depressive symptoms, this study systematically searched Web of Science, Medline, PubMed, CNKI, and other Chinese and English databases. A meta-analysis was conducted on 22 selected studies encompassing 36 effect sizes and involving 390,094 participants.

RESULTS

The results revealed a moderate negative correlation between parental educational involvement and adolescent depressive symptoms (r = -0.200, 95% CI [-0.26, -0.14]). Additionally, the relationship between parental educational involvement and adolescent depressive symptoms was found to be moderated by factors such as adolescent age, grade level and the reporter of parental educational involvement. However, it was not influenced by the female ratio or cultural background.

CONCLUSIONS

This study offers the inaugural comprehensive assessment of the relationship between parental educational involvement and adolescent depressive symptoms, with variations observed across different ages, grade levels, and reporter of parental educational involvement.

Parent-Child Mismatch in Educational Expectations and Depressive Symptoms among Chinese Adolescents

BACKGROUND

The roles of both parents' and children's educational expectations in shaping adolescent depressive symptoms have increasingly been discussed, yet in a separate manner. To date, few studies have associated parent-child mismatch in educational expectations with depressive symptoms, and less is known about the variation in the association across gender (male vs. female), educational level (primary vs. secondary), and region status (urban vs. rural) in the Chinese educational setting.

METHODS

Respondents were from a nationally representative sample of adolescent students in China (sample size: 1844; age range: 10-15 years). Parent-child mismatch in educational expectations included three categories: (1) "match", (2) "mismatch-parent higher", and (3) "mismatch-parent lower". Regression analysis with inverse propensity-score weighting was employed to estimate the effect of parent-child mismatch as to educational expectations on depressive symptoms, and stratified analysis was used to examine the variation of the effect by gender, educational level, and region.

RESULTS

Compared with the "match" group, the "mismatch-parent higher" group had significantly higher levels of depressive symptoms. Furthermore, the pattern remained consistent between boys and girls, but differed significantly by adolescents' educational level and region status. Specifically, the pattern was more pronounced in the primary school and urban subsamples.

CONCLUSIONS

Findings in this study indicated that educators and policymakers can develop tailored strategies to alleviate depressive symptoms among the "mismatch-parent higher" group, and especially for those children from primary schools and urban areas.

The Indirect Effect of Future Anxiety on the Relationship between Self-Efficacy and Depression in a Convenience Sample of Adults: Revisiting Social Cognitive Theory

Background/Objectives: Depression and anxiety are prevalent disorders, particularly during emerging adulthood. Uncertainty about the future, exacerbated by unstable times, can lead to heightened future anxiety in this group. This study aimed to examine the complex associations of depression symptoms, future anxiety, and self-efficacy in adults from Poland. Additionally, we investigated age and gender differences in depression symptoms, future anxiety, and self-efficacy. Methods: A cross-sectional online survey study was performed in 2023 in Poland using snowball sampling. A convenience sample of 284 adults participated in this study, ranging in age between 18 and 65 years old (M = 32.18, SD = 11.87), including 95 men (33.45%) and 189 (66.55%) women, and also 157 (55.63%) emerging adults (18-28 years old) and 126 (44.37%) middle-aged adults (29-65 years old). The Patient Health Questionnaire (PHQ-9), Dark Future Scale (DFS-5), and Generalized Self-Efficacy Scale (GSES) were used to measure depression, future anxiety, and self-efficacy, respectively. Results: A 2-way ANOVA showed that both emerging adults and women scored significantly higher in depression symptoms and future anxiety than middle-aged adults and men, respectively. Furthermore, women scored lower in self-efficacy than men. Analyses revealed that there was a positive correlation between depression and future anxiety. Self-efficacy was negatively correlated with depression and future anxiety. Self-efficacy and future anxiety accounted for 48% of depression variance, controlling for age and gender. Future anxiety was found to be a partial mediator of the relationship between self-efficacy and depression. Conclusions: This study significantly advances the understanding of mental health in adults, grounded in social cognitive theories, revealing that low self-efficacy heightens future anxiety, thereby exacerbating depression symptoms in the Polish adult population, independent of age and gender. Emerging adults and women need psychological support to reduce depression and future anxiety. Women, in particular, should be the main focus of interventions to boost self-efficacy. Implementing targeted preventive measures and support systems can mitigate the challenges faced by emerging adults and women.

Genetic Architectures of Adolescent Depression Trajectories in 2 Longitudinal Population Cohorts

Importance

Adolescent depression is characterized by diverse symptom trajectories over time and has a strong genetic influence. Research has determined genetic overlap between depression and other psychiatric conditions; investigating the shared genetic architecture of heterogeneous depression trajectories is crucial for understanding disease etiology, prediction, and early intervention.

Objective

To investigate univariate and multivariate genetic risk for adolescent depression trajectories and assess generalizability across ancestries.

Design, Setting, and Participants

This cohort study entailed longitudinal growth modeling followed by polygenic risk score (PRS) association testing for individual and multitrait genetic models. Two longitudinal cohorts from the US and UK were used: the Adolescent Brain and Cognitive Development (ABCD; N = 11 876) study and the Avon Longitudinal Study of Parents and Children (ALSPAC; N = 8787) study. Included were adolescents with genetic information and depression measures at up to 8 and 4 occasions, respectively. Study data were analyzed January to July 2023.

Main Outcomes and Measures

Trajectories were derived from growth mixture modeling of longitudinal depression symptoms. PRSs were computed for depression, anxiety, neuroticism, bipolar disorder, schizophrenia, attention-deficit/hyperactivity disorder, and autism in European ancestry. Genomic structural equation modeling was used to build multitrait genetic models of psychopathology followed by multitrait PRS. Depression PRSs were computed in African, East Asian, and Hispanic ancestries in the ABCD cohort only. Association testing was performed between all PRSs and trajectories for both cohorts.

Results

A total sample size of 14 112 adolescents (at baseline: mean [SD] age, 10.5 [0.5] years; 7269 male sex [52%]) from both cohorts were included in this analysis. Distinct depression trajectories (stable low, adolescent persistent, increasing, and decreasing) were replicated in the ALSPAC cohort (6096 participants; 3091 female [51%]) and ABCD cohort (8016 participants; 4274 male [53%]) between ages 10 and 17 years. Most univariate PRSs showed significant uniform associations with persistent trajectories, but fewer were significantly associated with intermediate (increasing and decreasing) trajectories. Multitrait PRSs-derived from a hierarchical factor model-showed the strongest associations for persistent trajectories (ABCD cohort: OR, 1.46; 95% CI, 1.26-1.68; ALSPAC cohort: OR, 1.34; 95% CI, 1.20-1.49), surpassing the effect size of univariate PRS in both cohorts. Multitrait PRSs were associated with intermediate trajectories but to a lesser extent (ABCD cohort: hierarchical increasing, OR, 1.27; 95% CI, 1.13-1.43; decreasing, OR, 1.23; 95% CI, 1.09-1.40; ALSPAC cohort: hierarchical increasing, OR, 1.16; 95% CI, 1.04-1.28; decreasing, OR, 1.32; 95% CI, 1.18-1.47). Transancestral genetic risk for depression showed no evidence for association with trajectories.

Conclusions and Relevance

Results of this cohort study revealed a high multitrait genetic loading of persistent symptom trajectories, consistent across traits and cohorts. Variability in univariate genetic association with intermediate trajectories may stem from environmental factors. Multitrait genetics may strengthen depression prediction models, but more diverse data are needed for generalizability.

Screening and treatment of anxiety symptoms within an interdisciplinary comprehensive epilepsy center

Youth with epilepsy (YWE) are at elevated risk for anxiety, yet anxiety is often undetected and understudied in this population. Most research on anxiety in YWE is based on parent proxy-report and broad-band measures with limited sensitivity. The aim of the current study was to: 1) examine rates of anxiety symptoms in YWE using a diagnosis-specific, self-report measure of anxiety symptoms, 2) assess differences in anxiety symptoms by sociodemographic and medical variables, and 3) evaluate changes in anxiety symptoms following a brief behavioral health intervention delivered within an interdisciplinary epilepsy clinic visit. As part of routine clinical care, 317 YWE [Mage=13.4+2.5 years (range 7-19 years); 54% female; 84% White: Non-Hispanic] completed the Multidimensional Anxiety Scale for Children, self-report (MASC-10), with a subset completing the MASC-10 at a second timepoint (n=139). A retrospective chart review was completed and sociodemographic, medical variables and behavioral health interventions were collected. Thirty percent of YWE endorsed elevated anxiety symptoms, with higher rates in those who were younger. YWE who received a behavioral health intervention for anxiety (n=21) demonstrated greater decreases in anxiety symptoms from Time 1 to Time 2 compared to those who did not receive a behavioral intervention (n=108). The integration of psychologists into pediatric epilepsy clinics may have allowed for early identification of anxiety symptoms, as well behavioral interventions to address these symptoms, which has the potential to decrease the need for more intensive services.

The impact of family socioeconomic status on depression in Chinese adolescents: A comparison of life course models

BACKGROUND

Low socioeconomic status (SES) is a well-recognized risk factor for depression. However, the relationship between the timing of exposure to disadvantaged SES in childhood and depression in adolescence remains to be explored. We examined the differential influence of SES in early childhood, late childhood and adolescence on adolescent depression by modeling life course models.

METHODS

We used longitudinal data from the China Family Panel Studies (N = 2245). SES was measured using average household income (objective SES) and maternal subjective SES and grouped into three time points: 5-8 years, 9-12 years, and 13-16 years of age. The main outcome was depression at 13-16 years of age. Structured linear regression analysis was used to predict depression by low SES over the three time periods. A partial F test was used to compare the nested life course models to the saturated model.

RESULTS

Among objective SES permutations, approximately 24.63 % of the adolescents had low SES in all periods, and 73.63 % had low SES in at least one period. Among subjective SES permutations, approximately 5.48 % of the adolescents had low SES in all periods, and 54.65 % had low SES in at least one period. Regardless of objective SES or subjective SES, the accumulation of risk (relaxed) model was the best-fit model. In this model, chronic low SES exposure in late childhood was the best predictor.

CONCLUSION

We suggest that interventions targeting the late childhood period may have a practical effect on reducing depression in adolescents.

Internet addiction and depressive symptoms in adolescents: joint trajectories and predictors

OBJECTIVE

Internet addiction and depressive symptoms are common mental health problems in adolescents. Due to the comorbidity of Internet addiction and depressive symptoms, their mutual relationship influences their developmental trajectories over time. Thus, this study aimed to identify the joint trajectories of Internet addiction and depressive symptoms, and examined the individual, family, and school antecedents of these trajectories among Chinese adolescents.

METHODS

Using a battery of self-report scales, three waves of data collection were conducted in a Chinese adolescent sample (N = 1,301). The co-developmental trajectories of Internet addiction and depressive symptoms were extracted by adopting parallel-process latent class growth modeling (PPLCGM). Multinomial logistic regression was performed to assess predictive factors.

RESULTS

Four unique joint trajectory classes were detected: the Health Group (n = 912, 70.1%), Comorbidity-Worsening Group (n = 85, 6.5%), Asymptomatic-Comorbid Risk Group (n = 148, 11.4%), and Prominent Depressive Symptoms-Remission Group (n = 156, 12.0%). Individual, family, and school factors (e.g., gender, positive youth development, family function, academic performance) significantly predicted the membership in these distinct co-developmental trajectories.

CONCLUSION

Our findings illustrate that the joint development of Internet addiction and depressive symptoms among adolescents presents a heterogeneous distribution, which could better inform prevention and intervention strategies since each co-developmental trajectory may represent unique experience for adolescents who need targeted treatment. Various individual, family, and school factors are important predictors that play different roles in distinguishing the joint trajectories of Internet addiction and depressive symptoms during this critical developmental transition period.

The Importance of Self-Regulation in the Development of Internalizing Symptoms During Middle Childhood

The Importance of Self-Regulation in the Development of Internalizing Symptoms During Middle Childhood Current research discusses low self-regulation abilities during childhood as risk factors for the development of internalizing symptoms. However, longitudinal studies investigatingmultiple self-regulation facets simultaneously are scarce. We examined whether impairments in various self-regulation facets (emotional reactivity, inhibition, inhibitory control, planning behavior) in middle childhood predict internalizing symptoms two years later and whether they make an incremental contribution when established risk factors (gender, family adversity) are considered. Furthermore, we investigated whether self-regulation facets predict later internalizing symptoms under consideration of internalizing symptoms at baseline.The sample consisted of 1,617 children (t1:Mage = 9.1, t2:Mage = 11.1 years), assessed at two measurement points. Internalizing symptoms were rated by parents on the Emotional Problems Scale of the Strengths and Difficulties Questionnaire. Self-regulation facets were measured at the first measurement point using various methods and informants. A stepwise regression analysis revealed that increased emotional reactivity, reduced inhibitory control, and reduced planning behavior significantly predicted later internalizing symptoms, explaining 14.8 % of the variance. Adding risk factors increased the explained variance by 2.5 %. Under consideration of baseline internalizing symptoms, reduced inhibition and inhibitory control significantly predicted later internalizing symptoms, while other self-regulation facets and risk factors did not. Results of this study may inform prevention and intervention measures.

Examining Predictors of Psychological Distress Among Youth Engaging with Jigsaw for a Brief Intervention

Risk factors for psychological distress among help-seeking youth are poorly understood. Addressing this gap is important for informing mental health service provision. This study aimed to identify risk factors among youth attending Jigsaw, a youth mental health service in Ireland. Routine data were collected from N = 9,673 youth who engaged with Jigsaw (Mean age = 16.9 years, SD = 3.14), including presenting issues, levels of psychological distress, age, and gender. Confirmatory Factor Analysis identified thirteen factors of clustering issues. Several factors, including Self-criticism and Negative Thoughts, were strongly associated with items clustering as psychological distress, however these factors were poorly predictive of distress as measured by the CORE (YP-CORE: R2 = 14.7%, CORE-10: R2 = 6.9%). The findings provide insight into associations between young people's identified presenting issues and self-identified distress. Implications include applying appropriate therapeutic modalities to focus on risk factors and informing routine outcome measurement in integrated youth mental health services.

Psychometric properties and normative data of the Latvian and Russian language versions of the strengths and difficulties questionnaire (SDQ) in the Latvian general adolescent population

OBJECTIVES

Mental health screening instruments are essential in population health research and clinical practice. The strengths and difficulties questionnaire (SDQ) self-report version has been widely used across the globe to screen for mental health problems in adolescent populations. This study aimed to explore the psychometric properties of the Latvian and Russian language versions of the SDQ in a representative sample of a general population of Latvian adolescents and establish the population-based normative scores.

MATERIALS AND METHODS

This analysis was based on data from the international Health Behaviour in School-aged Children study year 2017/2018 Latvian database. The sample comprised 2683 Latvian and 1321 Russian-speaking 11-, 13-, and 15-year-old adolescents.

RESULTS

Significant language-based variance was observed in the mean scores of the externalising subscales of the SDQ, with Latvian-speaking adolescents reporting higher levels of conduct problems and hyperactivity. The reliability was satisfactory (ordinal alpha >0.7) only for the prosocial behaviour, emotional, internalising problems, and total difficulties subscales, while conduct, hyperactivity, peer, and externalising problems scales demonstrated lower internal consistency (ordinal alpha 0.5-0.7). Confirmatory factor analysis (CFA) did not support the hypothesised narrow-band five-factor or broad-band three-factor structure of the SDQ. The normative banding scores were calculated for both language variants.

CONCLUSIONS

This study suggests that the self-report SDQ must be used cautiously in Latvian adolescents because some SDQ subscales lack reliability. When used in population research, the internalising subscales seem more reliable than the externalising ones. More research is needed regarding the reliability of the SDQ in clinical adolescent populations.

A prospective longitudinal study of multidomain resilience among youths with and without maltreatment histories

The majority of children with maltreatment histories do not go on to develop depression in their adolescent and adult years. These individuals are often identified as being "resilient", but this characterization may conceal difficulties that individuals with maltreatment histories might face in their interpersonal relationships, substance use, physical health, and/or socioeconomic outcomes in their later lives. This study examined how adolescents with maltreatment histories who exhibit low levels of depression function in other domains during their adult years. Longitudinal trajectories of depression (across ages 13-32) in individuals with (n = 3,809) and without (n = 8,249) maltreatment histories were modeled in the National Longitudinal Study of Adolescent to Adult Health. The same "Low," "increasing," and "declining" depression trajectories in both individuals with and without maltreatment histories were identified. Youths with maltreatment histories in the "low" depression trajectory reported lower romantic relationship satisfaction, more exposure to intimate partner and sexual violence, more alcohol abuse/dependency, and poorer general physical health compared to individuals without maltreatment histories in the same "low" depression trajectory in adulthood. Findings add further caution against labeling individuals as "resilient" based on a just single domain of functioning (low depression), as childhood maltreatment has harmful effects on a broad spectrum of functional domains.

Protective factors against depression in high-risk children and adolescents: a systematic review of longitudinal studies

OBJECTIVE

From a preventive perspective, this study reviewed the literature on protective factors against depressive symptoms in high-risk children and adolescents.

METHODS

We conducted a thorough search of the PubMed, APA, EMCare, and Embase databases for studies published between 1946 and August 25, 2023. We included only longitudinal studies that analyzed protective factors for depressive symptoms in high-risk children or adolescents, excluding cross-sectional studies, reviews, and pre-clinical studies.

RESULTS

A total of 29 studies with 62,405 participants were analyzed and 38 protective factors were identified. Positive individual characteristics, family factors, peer relationships, school-related aspects, neighborhood characteristics, and intrinsic religiosity were associated with improved depression outcomes.

CONCLUSION

These findings have important implications for preventive strategies in this population. Addressing protective factors can help prevent depression and enhance lifetime mental health.

Family socioeconomic status and adolescent depression in urban and rural China: A trajectory analysis

Background

Depression is increasingly prevalent among Chinese adolescents, with socioeconomic status (SES) serving as a significant predictor. Understanding the link between family SES and depression is of paramount concern. This study aimed to delineate the developmental paths of depressive symptoms among urban and rural Chinese adolescents, focusing on the influence of family SES on these trajectories.

Methods

Data from the China Family Panel Studies (CFPS) for 2012, 2016, and 2018 were used in this study. Participants were individuals aged 10 to 15 in the 2012 wave who also participated in the 2016 and 2018 waves (N = 1214). Family SES was measured by household income, parental education, and occupational status, while depressive symptoms were measured by the Center for Epidemiologic Studies Depression (CES-D) scale. Employing the Growth Mix Model (GMM) unveiled depression trajectories, while logistic regression scrutinized the impact of family SES on these trajectories.

Results

The study identified three depression trajectories in urban adolescents: high-decreasing, low-stable, and low-rising levels of depressive symptoms, and two depression trajectories in rural adolescents: high-decreasing and low-stable levels of depressive symptoms. On average, rural adolescents reported higher depression levels than urban peers. In urban areas, adolescents with higher maternal education and parental occupation were more likely to be classified in the low-stable trajectory, while in rural areas only maternal education had predictive power for depression trajectories.

Conclusions

Depression trajectories differ between urban and rural in China. Maternal education is an important factor influencing rural sample grouping. Targeted interventions could be implemented to reduce depression in adolescents.

Individual Trajectories of Depressive Symptoms Within Racially-Ethnically Diverse Youth: Associations with Polygenic Risk for Depression and Substance Use Intent and Perceived Harm

There are distinct individual trajectories of depressive symptoms across adolescence which are most often differentiated into low, moderate/stable, and high/increasing groups. Research has found genetic predisposition for depression associated with trajectories characterized by greater depressive symptoms. However, the majority of this research has been conducted in White youth. Moreover, a separate literature indicates that trajectories with elevated depressive symptoms can result in substance use. It is critical to identify depressive symptom trajectories, genetic predictors, and substance use outcomes in diverse samples in early adolescence to understand distinct processes and convey equitable benefits from research. Using data from the Adolescent Cognitive Brain Development Study (ABCD), we examined parent-reported depressive symptom trajectories within Black/African American (AA, n = 1783), White/European American (EA, n = 6179), and Hispanic/Latinx (LX, n = 2410) youth across four annual assessments in early adolescence (age 9-10 to 12-13). We examined racially/ethnically aligned polygenic scores (Dep-PGS) as predictors of trajectories as well as substance use intent and perceived substance use harm as outcomes at age 12-13. Differential trajectories were found in AA, EA, and LX youth but low and high trajectories were represented within each group. In EA youth, greater Dep-PGS were broadly associated with membership in trajectories with greater depressive symptoms. Genetic effects were not significant in AA and LX youth. In AA youth, membership in the low trajectory was associated with greater substance use intent. In EA youth, membership in trajectories with higher depressive symptoms was associated with greater substance use intent and less perceived harm. There were no associations between trajectories and substance use intent and perceived harm in LX youth. These findings indicate that there are distinct depressive symptom trajectories in AA, EA, and LX youth, accompanied by unique associations with genetic predisposition for depressive symptoms and substance use outcomes.

Factor structure and measurement invariance of the 8-item CES-D: a national longitudinal sample of Chinese adolescents

BACKGROUND

The 8-item Center for Epidemiologic Studies Depression Scale (CES-D 8) has been widely used to measure depressive symptoms in many large-scale surveys. Due to its brevity, it can lower costs, relieve respondent burdens, and ensure data quality. However, its factor structure and measurement invariance across gender and time among adolescents have not been adequately evaluated. This study investigated its factor structure and measurement invariance across gender and time among adolescents.

METHODS

The data was drawn from the China Family Panel Studies (CFPS) conducted in 2018 and 2020, with 3099 participants (46.82% girls) aged 11 to 18 in 2018. First, exploratory and confirmatory factor analyses were used to examine the factor structure of the CES-D 8. Next, multi-group confirmatory factor analysis was conducted to test its measurement invariance across gender and time. Finally, a longitudinal cross-gender test was conducted to further confirm the stability of the scale.

RESULTS

A two-factor structure was identified among the adolescents, including Negative Symptoms and Diminished Happiness Feeling. Measurement invariance across gender and time, as well as the longitudinal cross-gender invariance, was supported, with configural, factor loadings, thresholds and residual invariance.

CONCLUSIONS

The factor structure of the CES-D 8 remains stable across gender and time among adolescents, indicating that it is a promising instrument for measuring depressive symptoms, especially in large-scale and longitudinal surveys.

Psychosocial Factors Influencing Quality of Life Among Medical Students

OBJECTIVE

This study investigated the influence of psychosocial factors on medical students' quality of life (QOL).

METHODS

A total of 408 medical students participated in this study. We collected data on participants' sociodemographic details, symptoms of depression and Internet addiction, self-esteem, social support, and QOL. QOL was assessed using the World Health Organization Quality of Life-Abbreviated form, which has four domains (physical health, psychological health, social relationships, and environment). A stepwise multiple linear regression model was constructed to identify factors' independent impact on QOL.

RESULTS

Higher levels of depression and Internet addiction were associated with lower scores in all domains of QOL, whereas higher levels of self-esteem and social support were associated with higher scores. Being in third-year versus first-year was associated with higher scores in the physical health and environment domains. Living alone or in dormitories, low or middle socioeconomic status, and insufficient or moderate pocket money were associated with lower scores in the environment domain. Additionally, female students displayed significantly lower scores for physical health, psychological health, and environment than male students, but not for social relationships. There were significant differences in certain domains of QOL due to sociodemographic factors.

CONCLUSION

This study demonstrates the psychosocial factors influencing medical students' QOL. Educational strategies focusing on strengthening self-esteem and social support as well as preventing depression and Internet addiction may contribute to improving medical students' QOL.

Characterizing the profiles of patients with acute concussion versus prolonged post-concussion symptoms in Ontario

Identifying vulnerability factors for developing persisting concussion symptoms is imperative for determining which patients may require specialized treatment. Using cross-sectional questionnaire data from an Ontario-wide observational concussion study, we compared patients with acute concussion (≤ 14 days) and prolonged post-concussion symptoms (PPCS) (≥ 90 days) on four factors of interest: sex, history of mental health disorders, history of headaches/migraines, and past concussions. Differences in profile between the two groups were also explored. 110 patients with acute concussion and 96 patients with PPCS were included in our study. The groups did not differ on the four factors of interest. Interestingly, both groups had greater proportions of females (acute concussion: 61.1% F; PPCS: 66.3% F). Patient profiles, however, differed wherein patients with PPCS were significantly older, more symptomatic, more likely to have been injured in a transportation-related incident, and more likely to live outside a Metropolitan city. These novel risk factors for persisting concussion symptoms require replication and highlight the need to re-evaluate previously identified risk factors as more and more concussions occur in non-athletes and different risk factors may be at play.

Self-regulation facets differentially predict internalizing symptom trajectories from middle childhood to early adolescence: a longitudinal multimethod study

BACKGROUND

Internalizing symptoms are among the most common psychological symptoms in childhood and adolescence, are highly stable and can cause severe impairment. Current research discusses lower capacities of self-regulation (SR) as risk factors for the development of internalizing symptoms. The present study identifies trajectories of internalizing symptoms in the transition phase from middle childhood to adolescence and examines multiple SR facets as predictors of potentially unfavorable trajectories, also in the presence of other established risk factors.

METHODS

The study utilized a community sample of N = 1453 (52.2% female) German children, who provided data at up to three measurement points (t1: 6-11 years, t2: 7-11 years, t3: 9-13 years). Trajectories of internalizing symptoms were based on parents' ratings of the emotional problems scale of the Strengths and Difficulties Questionnaire. SR facets were assessed using multiple methods and informants. Two multinomial regression analyses were conducted to predict class membership by (1) SR facets and gender and (2) SR facets, gender, and other established risk factors (education status, family adversity, peer problems).

RESULTS

Using growth mixture modelling, we identified three trajectory classes with stable low (n = 1200), increasing (n = 124), and early high decreasing internalizing symptoms (n = 129). In the regression analysis controlling for risk factors, membership in the increasing trajectory was significantly predicted by higher emotional reactivity (OR = 2.65, p < .001), higher cognitive flexibility/set-shifting (OR = 1.48, p = .032), and higher family adversity (OR = 1.38, p = .046). Membership in the early high decreasing trajectory was significantly predicted by higher emotional reactivity (OR = 4.15, p < .001), higher inhibitory control (OR = 1.47, p = .045), lower working-memory updating (OR = 0.69, p = .016), lower delay of gratification (OR = 0.75, p = .028), and higher family adversity (OR = 1.63, p = .001).

CONCLUSIONS

SR facets incrementally and differentially predict potentially unfavorable trajectories of internalizing symptoms from age 6 to 13, surpassing the predictive value of gender or education status. Higher emotional reactivity emerged as the most influential factor, which could therefore be addressed in future prevention and intervention efforts.

Perceived Neighborhood Safety and Depressive Symptoms: The Role of Perceived Neighborhood Cohesion and Perceived Control

Few have examined mechanisms explaining the link between perceived neighborhood unsafety, neighborhood social processes, and depressive symptoms for Black adolescents. The goal of this study was to examine the role of perceived control as a mechanism linking perceptions of neighborhood unsafety and depressive symptoms, and neighborhood cohesion as a protective factor. Participants were 412 Black adolescents living in a major Mid-Atlantic urban center in the United States (49% female, Mage = 15.80, SD = 0.36). Participants reported perceptions of neighborhood unsafety at grade 10, neighborhood cohesion at grade 10, perceived control at grades 10 and 11 and depressive symptoms in grades 10 and 12. High neighborhood unsafety was associated with low perceived control and in turn high depressive symptoms only when neighborhood cohesion was high. The results highlight the role of neighborhood unsafety and perceived control in the development of depressive symptom and the possible downsides of neighborhood social factors.

Adolescents' stress and depressive symptoms and their associations with psychological flexibility before educational transition

INTRODUCTION

Relatively little is known about individual differences in adolescent psychological flexibility and its associations with symptoms of stress and depression. This study examined different profiles of adolescent stress and depressive symptoms and their associations with developing psychological flexibility before the critical educational transition.

METHODS

The data were derived from a general sample of 740 Finnish ninth-grade adolescents (Mage  = 15.7 years, 57% female) who were assessed twice during the final grade of their basic education. The data were analyzed using growth mixture modeling.

RESULTS

Four profiles of stress and depressive symptoms were identified during a school year: (1) no stress and no depressive symptoms (None; 69%); (2) mild and decreasing stress and depressive symptoms (Decreasing; 15%); (3) low but increasing stress and depressive symptoms (Increasing; 6%); and (4) high and stable levels of stress and depressive symptoms (High; 10%). The adolescents in these profiles differed from each other in their initial levels and changes of psychological flexibility. The initial level of psychological flexibility was highest in the no-symptom profile group. We observed simultaneous change trends in symptoms and psychological flexibility during a school year. When symptoms decreased, psychological flexibility increased, and when symptoms increased, psychological flexibility decreased.

CONCLUSIONS

A bidirectional pattern of relationships between psychological flexibility and psychological symptoms was found. Despite initially high level of skills in psychological flexibility, some adolescents, unexpectedly, experienced increased symptoms of stress and depression during the school year. The results call for further studies to explore in-depth the developmental diversity in adolescents' well-being and its antecedents.

Association between healthy sleep patterns and depressive trajectories among college students: a prospective cohort study

BACKGROUND

The purpose of this study was to identify different develpment trajectories of depression symptoms during college period, and prospectively investigate the associations healthy sleep patterns with trajectories of depression symptoms among college students from freshman through junior year.

METHODS

A total of 999 participants from the College Student Behavior and Health Cohort Study were included between April 2019 and June 2021. Healthy sleep patterns were defined by chronotype, sleep duration, insomnia, snoring, and daytime sleepiness. Latent growth curve model was used to identify trajectories of depression symptoms. Then binary logistic regression was used to examine association of the healthy sleep patterns with these trajectories.

RESULTS

In baseline survey, we found that a total of 100 (10.0%) participants had healthy sleep patterns' score equal to 5. Then, we used 5 surveys' data to identify 2 distinct trajectories of depression symptoms during college (decreasing: 82.5%; increasing: 17.5%). The healthy sleep patterns were associated with these trajectories, the better healthy sleep patterns significantly decrease the risk of increasing trajectories of depression symptoms in males (OR: 0.72, 95%CI: 0.54 ~ 0.97, P = 0.031). Moreover, we found out that the healthy sleep patterns of college students can predict the future depressive symptoms in this study (all P < 0.001).

CONCLUSION

Our findings indicate that the better healthy sleep patterns may significantly decrease the risk of increasing trajectory of depression symptoms only in male college students. The results speak to a need for college student with depression symptoms to identify and address sleep problems when present, which could prevent or reduce depression detriments in later life.

Context-relevant risk and protective factors for children in rural communities: Long-term implications for adulthood educational and mental health outcomes

Globally, rural children are more likely than others to experience barriers to opportunity. We propose context-relevant family risk and protective factors for children in rural villages in one of China's poorest provinces and analyze long-term implications for educational and mental health outcomes in early adulthood. Four proposed risk factors-low parental education, insufficient income, parental migration, and parental ill-health-show statistically significant detrimental implications for educational attainment. Low parental education stands out, with negative estimated effects on all outcomes. Insufficient income predicts higher scores for depression but not self-esteem. Parental migration and parental ill health have no significant relationships with mental health outcomes. Proposed protective factors- parental warmth, doing things together, and household credit limit-have positive estimated effects on educational attainment, but not on most mental health outcomes. Few interactions between protective and risk factors exist, and patterns are generally similar for girls and boys.

Prospective and Contemporaneous Relations of Self-Esteem and Depressed Affect in the Context of Parent-Child Closeness during Adolescence: A Random-Intercept Cross-Lagged Panel Model

Adolescent self-esteem and depression are influenced by important psychosocial factors such as parental relationships, yet it is unclear how these within-person relations present over time. The current study investigates the longitudinal relations between self-esteem, depressed affect, and parent-adolescent closeness during middle adolescence. Adolescents (n = 562; mean age = 14.73, SD = 0.82; 52% female; 72% White, 28% Racial Minority) were surveyed annually over four years (1988-1991). A random-intercept cross-lagged panel model was applied to disaggregate between- and within-person associations. Consistent with the scar model, adolescents experiencing heightened depressed affect were likely to have lower self-esteem. Furthermore, perceived mother-adolescent, but not father-adolescent, closeness positively predicted adolescent self-esteem. The results highlight the importance of considering interpersonal relationships and age in developmental models of self-esteem and depression.

Analyzing risky behaviors among different minority and majority race in teenagers in the USA using latent classes

Objective: This study is to ascertain any inconsistencies in the trend of co-occurrence by sex of teenage health risk behavior patterns such as smoking, behaviors contributing to deliberate and unintentional injuries, risky sexual behavior, and sedentary lifestyle. Methods: The study's purpose was accomplished using Youth Risk Behavior Surveillance System (YRBSS) 2013 data. A Latent Class Analysis (LCA) was conducted for the entire sample of teenagers as well as separately for each sex. Results: In this subset of youths, marijuana use was acknowledged by more than half of them, and smoking cigarettes was far more likely. More than half of the individuals in this subset engaged in risky sexual practices, like not using a condom during their most recent encounter. Males were split into three categories based on their involvement in risky behavior, while females were split into four subgroups. Conclusion: Regardless of gender, various risk behaviors among teenagers are connected. However, gender variations in the higher risk of particular trends, such as mood disorders and depression among females, underline the significance of creating treatments that take adolescent demographics into account.

Understanding stability and change in depressive symptom trajectories across young adulthood through the lens of career development: A mixed-methods study

Research has documented both stable and nonstable trajectories of depressive symptoms across young adulthood, but has not explored the mechanisms that might explain change in level of depressive affect over time. To explore this question, the current study draws on data from an Israeli longitudinal study of 205 young adults who reported their depressed symptoms four times from ages 23 to 35 years. Employing a latent profile analysis (LPA), three distinct trajectories of depressive symptoms were identified: stable low, moderate and decreasing, and stable high. To understand how stability and change in the course of depressive symptoms across time aligns with career development, 60 participants (20 from each profile), who had completed in-depth career development history interviews at age 29, were randomly selected. Subjecting the interviews to qualitative analysis showed that participants belonging to the stable low depressive symptoms trajectory were more likely to be intrinsically motivated, having the capacity to learn from their experiences, which resulted in a more successful career pursuit. In contrast, participants who consistently exhibited a high level of depressive affect were more likely to lack motivation, tended to feel at a loss, and were less likely to know what they want to do with their lives. Participants who were identified as belonging to the moderate and decreasing trajectory were more likely to describe the lack of a clear view of their future career plans. However, due to encouragement from significant others, they eventually found their niche. Conceptually, findings underscore the importance of understanding career factors that could covary with stability or change in the level of depressive symptoms during young adulthood.

Trajectories of depression for Latino immigrant adolescents: The influence of individual, family, and sociocultural factors

Latino immigrant adolescents represent a high-risk group for developing depression. Such risk for depression becomes more salient in emerging destination contexts (e.g., Oregon) where immigrant youth face considerably more stressors compared to traditional contexts (e.g., Texas, New York, and California). However, no study to date has considered how depression unfolds over time among Latino immigrant youth in emerging contexts. Using data from a three-wave prospective longitudinal design across 3 years, we employed latent growth curve (LGC) modeling to assess depression trajectories among 217 Latino immigrant families in the emerging context of western Oregon. Moreover, we assessed the influence of salient predictors on these trajectories across individual (gender and time in U.S. residency), family (family cultural stress, effective parenting practices, parent depression), and sociocultural (ethnic discrimination) levels. Results from LGC revealed that youth, on average, followed a decreasing trajectory of depression. Furthermore, identifying as female and higher levels of parent depression significantly predicted higher baseline levels of youth depression. No significant predictors emerged for the slope. However, follow-up analyses from multiple-group LGCs found that, whereas males were stable in their trajectories, females exhibited significantly more variability in their initial levels of depression and slopes over time. Moreover, when considered separately, predictors were significant only for females such that parent depression predicted higher baseline depression scores, and family cultural stress predicted a more slowly decreasing slope. Results suggest that Latina immigrant females are more variable in their depression patterns than males and may be more sensitive to family-related stressors that contribute to depression. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Prediction of depressive symptoms onset and long-term trajectories in home-based older adults using machine learning techniques

OBJECTIVES

Our aim was to explore the possibility of using machine learning (ML) in predicting the onset and trajectories of depressive symptom in home-based older adults over a 7-year period.

METHODS

Depressive symptom data (collected in the year 2011, 2013, 2015 and 2018) of home-based older Chinese (n = 2650) recruited in the China Health and Retirement Longitudinal Study (CHARLS) were included in the current analysis. The latent class growth modeling (LCGM) and growth mixture modeling (GMM) were used to classify different trajectory classes. Based on the identified trajectory patterns, three ML classification algorithms (i.e. gradient boosting decision tree, support vector machine and random forest) were evaluated with a 10-fold cross-validation procedure and a metric of the area under the receiver operating characteristic curve (AUC).

RESULTS

Four trajectories were identified for the depressive symptoms: no symptoms (63.9%), depressive symptoms onset {incident increasing symptoms [new-onset increasing (16.8%)], chronic symptoms [slowly decreasing (12.5%), persistent high (6.8%)]}. Among the analyzed baseline variables, the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) score, cognition, sleep time, self-reported memory were the top five important predictors across all trajectories. The mean AUCs of the three predictive models had a range from 0.661 to 0.892.

CONCLUSIONS

ML techniques can be robust in predicting depressive symptom onset and trajectories over a 7-year period with easily accessible sociodemographic and health information.

Supplemental data for this article is available online at http://dx.doi.org/10.1080/13607863.2022.2031868.

A hybrid machine learning model of depression estimation in home-based older adults: a 7-year follow-up study

BACKGROUND

Our aim was to explore whether a two-step hybrid machine learning model has the potential to discover the onset of depression in home-based older adults.

METHODS

Depression data (collected in the year 2011, 2013, 2015 and 2018) of home-based older Chinese (n = 2,548) recruited in the China Health and Retirement Longitudinal Study were included in the current analysis. The long short-term memory network (LSTM) was applied to identify the risk factors of participants in 2015 utilizing the first 2 waves of data. Based on the identified predictors, three ML classification algorithms (i.e., gradient boosting decision tree, support vector machine and random forest) were evaluated with a 10-fold cross-validation procedure and a metric of the area under the receiver operating characteristic curve (AUROC) to estimate the depressive outcome.

RESULTS

Time-varying predictors of the depression were successfully identified by LSTM (mean squared error =0.8). The mean AUCs of the three predictive models had a range from 0.703 to 0.749. Among the prediction variables, self-reported health status, cognition, sleep time, self-reported memory and ADL (activities of daily living) disorder were the top five important variables.

CONCLUSIONS

A two-step hybrid model based on "LSTM+ML" framework can be robust in predicting depression over a 5-year period with easily accessible sociodemographic and health information.

Has the "Double Reduction" policy relieved stress? A follow-up study on Chinese adolescents

PURPOSE

"Double Reduction" Policy requires schools to reduce the burden of excessive homework and off-campus training for Chinese students to reduce their academic stress and promote mental health. We conducted a study in compulsory education students before and after the "Double Reduction" Policy to explore changes in mental health problems and relevant influential factors.

METHODS

A total of 28,398 elementary and junior high school students completed both waves of the survey through electronic questionnaires. Depressive symptoms were assessed using the Patient Heath Questionnaire (PHQ-9), and anxiety symptoms were assessed using the Generalized Anxiety Disorder Scale (GDA-7). Demographic information was evaluated at baseline, and "Double Reduction" related factors and negative life events were measured at follow up.

RESULTS

The overall depression and anxiety levels significantly decreased after the "Double Reduction" Policy. Girls, poor parental marital quality, chronic physical illness, and psychiatric family history were related to increased occurrence of mental health. Sleep duration > 8 h/night, reduced homework, more extracurricular activities more time with parents, and reduced academic stress were protective factors against mental health problems.

CONCLUSIONS

The "Double Reduction" Policy has improved the mental health symptoms of students to a certain extent. Appropriately increasing sleep time, participating in more extracurricular activities and parental involvement, and reducing the burden of homework are effective ways to promote the development of students' mental health.

Father absence and trajectories of offspring mental health across adolescence and young adulthood: Findings from a UK-birth cohort

BACKGROUND

High prevalence of parental separation and resulting biological father absence raises important questions regarding its impact on offspring mental health across the life course. We specifically examined whether these relationships vary by sex and the timing of exposure to father absence (early or middle childhood).

METHODS

This study is based on up to 8409 children from the Avon Longitudinal Study of Parents and Children (ALSPAC). Participants provided self-reports of depression (Clinical Interview Schedule-Revised) at age 24 years and depressive symptoms (Short Mood and Feelings Questionnaire) between the ages of 10 and 24 years. Biological father absence in childhood was assessed through maternal questionnaires at regular intervals from birth to 10 years. We estimated the association between biological father absence and trajectories of depressive symptoms using multilevel growth-curve modelling.

RESULTS

Early but not middle childhood father absence was strongly associated with increased odds of offspring depression and greater depressive symptoms at age 24 years. Early childhood father absence was associated with higher trajectories of depressive symptoms during adolescence and early adulthood compared with father presence. Differences in the level of depressive symptoms between middle childhood father absent and father present groups narrowed into adulthood.

LIMITATIONS

This study could be biased by attrition and residual confounding.

CONCLUSIONS

We found evidence that father absence in childhood is persistently associated with offspring depression in adolescence and early adulthood. This relationship varies by sex and timing of father's departure, with early childhood father absence emerging as the strongest risk factor for adverse offspring mental health trajectories Further research is needed to identify mechanisms that could inform preventative interventions to reduce the risk of depression in children who experience father absence.

Residential mobility, neighborhood cohesion, and depressive symptoms among urban-dwelling African American adolescents

Mechanisms linking residential mobility and depressive symptoms among urban-dwelling African American adolescents have received little attention. This study examined neighborhood cohesion as a possible mechanism. Participants were 358 urban-dwelling African American adolescents (Mage  = 14.78; SD = 0.34) who reported their neighborhood cohesion in Grade 10 and depressive symptoms in Grades 9 and 11, and for whom residential address information was available. There was a significant indirect effect of past moves in middle school on depressive symptoms 1 year later through reduced neighborhood cohesion. However, the indirect effect was not significant in a propensity score-matched sample. Results from the full sample of adolescents suggest that neighborhood cohesion may play a role in the experience of depressive symptoms following past moves in middle school. Different findings for the propensity score-matched sample highlight the need for future studies of residential mobility to employ strategies to correct for possible selection bias.

Detecting negative valence symptoms in adolescents based on longitudinal self-reports and behavioral assessments

BACKGROUND

Given the high prevalence of depressive symptoms reported by adolescents and associated risk of experiencing psychiatric disorders as adults, differentiating the trajectories of the symptoms related to negative valence at an individual level could be crucial in gaining a better understanding of their effects later in life.

METHODS

A longitudinal deep learning framework is presented, identifying self-reported and behavioral measurements that detect the depressive symptoms associated with the Negative Valence System domain of the NIMH Research Domain Criteria (RDoC).

RESULTS

Applied to the annual records of 621 participants (age range: 12 to 17 years) of the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA), the deep learning framework identifies predictors of negative valence symptoms, which include lower extraversion, poorer sleep quality, impaired executive control function and factors related to substance use.

LIMITATIONS

The results rely mainly on self-reported measures and do not provide information about the underlying neural correlates. Also, a larger sample is required to understand the role of sex and other demographics related to the risk of experiencing symptoms of negative valence.

CONCLUSIONS

These results provide new information about predictors of negative valence symptoms in individuals during adolescence that could be critical in understanding the development of depression and identifying targets for intervention. Importantly, findings can inform preventive and treatment approaches for depression in adolescents, focusing on a unique predictor set of modifiable modulators to include factors such as sleep hygiene training, cognitive-emotional therapy enhancing coping and controllability experience and/or substance use interventions.

The short and long-term impact of the healthy kids initiative on depressed mood in youth living with obesity

PURPOSE

The purpose of this study is to determine the effect of a free, comprehensive program with social support on depressed mood in youth (aged 11-17 years) living with obesity in a prospective, longitudinal, community-based study.

METHODS

Youth living with obesity (BMI > 30), residing in three cities in Saskatchewan, Canada, were eligible to participate in a 12-week program designed to facilitate behavioural change with five physical activity sessions a week, one dietary session a week, and one group cognitive behavioural session per week offered by health care professionals. Baseline data were collected on depressed mood (Centre for Epidemiological Studies-Depression 12 or CES-D 12), health-related quality of life (SF-12), and self-esteem (NLSCY) at baseline, 12-weeks, and at 52-weeks RESULTS: Overall, 2598 youth started and 2292 (88.2 %) completed the 12-week program with 1703 (74.3 %) of participants presenting for 52-week follow-up. Depressed mood improved significantly over the course of the program: 79.2 % of participants had depressed mood at the start of the program and this decreased to 64.7 % at the end of 12-weeks; which was an overall relative reduction of 18.4 % (Cohen's d = 0.94). The mean CES-D 12 score at one-year was significantly lower than the mean baseline score (17.90 compared to 21.11, p < .001). By depressed mood severity, 58.7 % of participants had severe depressed mood at baseline, which reduced to 31.6 % at 12 weeks, and 27.9 % at 52 weeks. Age and maternal occupation were initially significantly associated with depressed mood at 52-week follow-up (unadjusted). However, after binary logistic regression was used to determine the independent risk factors for having depressed mood at 52-week follow up, only older age (OR 1.88, 95 % CI 1.52-2.34, p < .001) was significant.

CONCLUSION

The Healthy Kids Initiative lends more evidence that healthy behavioural interventions can have a positive impact on depressed mood among youth living with obesity.

The role of socioeconomic status in different trajectories of depressive symptoms in Chinese college freshmen

The associations between socioeconomic status (SES) and depressive symptoms have been found in previous studies. However, the role of SES in different trajectories of depressive symptoms in Chinese college freshmen has not been discovered. The present study aims to identify how depressive symptom trajectories are related to SES during the first semester of freshman. Six hundred fifty-two Chinese college freshmen (64.9% female) were followed 4 times across 4 months. The Latent Growth Mixture Model (LGMM) was used to identify trajectories of depressive symptoms. Multinomial Logical Regression was used to identify the influence of family socioeconomic status (FSES), subjective socioeconomic status (SSS), and demographic variables on trajectories of depressive symptoms for freshmen. Results found that college freshmen’s depressive symptoms gradually decreased during the four tests, F(2.758, 1795.383) = 52.642, p < 0.001, and there are three trajectories of depressive symptoms: normal group (Class 1, 73.1%), depression risk group (Class 2, 20.7%), and depression deterioration group (Class 3, 6.1%). The decline of SSS predicted increasing depressive symptoms. Age and left-behind experience have significant effects on trajectories of depressive symptoms. FSES, birthplace, and gender had no significant impact on trajectories of depressive symptoms. These results demonstrated that low SSS, age, and left-behind might be risk factors for the development of depressive symptoms.

Risks and Resources for Depressive Symptoms and Anxiety in Children and Adolescents During the COVID-19 Pandemic - Results of the Longitudinal COPSY Study

Background

Mental health during the COVID-19 pandemic is of particularly high relevance. Especially for children and adolescents, the pandemic and its restrictions represent a significant burden. The present study aims to identify risks and resources for depressive symptoms and anxiety in children and adolescents during the pandemic in Germany.

Materials and Methods

Self-reported data from the first wave of the longitudinal COVID-19 and Psychological Health (COPSY) study were used to investigate risks and resources among n = 811 children and adolescents aged 11-17 years. Depressive symptoms and anxiety were measured at the first follow-up 6 months later. Multivariate linear regression analyses were performed to investigate the effects of risks and resources on depressive symptoms and anxiety.

Results

Parental depressive symptoms predicted depressive symptoms and anxiety in children and adolescents 6 months later. Female gender was identified as a risk factor for anxiety during the pandemic. None of the potential resources were associated with depressive symptoms or anxiety at the follow-up.

Conclusion

The findings provide evidence of risk factors for depressive symptoms and anxiety during the COVID-19 pandemic. Children and adolescents who face risk factors need to be identified early and monitored during the pandemic. Family-based intervention programs are needed to help vulnerable children and adolescents cope with the challenges of the pandemic.

Ego-resiliency moderates the risk of depression and social anxiety symptoms on suicidal ideation in medical students

BACKGROUND

Little is known about the role of protective factors in suicidal ideation among medical students. This study aimed to examine the association between suicidal ideation and protective (self-esteem/ego-resiliency/social support) and risk (depression/social anxiety) factors.

METHODS

Data on sociodemographic factors, depression, social anxiety, self-esteem, ego-resiliency, social support, and current suicidal ideation were collected from 408 medical students. A logistic regression model was constructed to identify the independent impact of potential influencing factors on suicidal ideation. Potential moderating effects were also explored.

RESULTS

Thirty-eight participants (9.3%) reported experiencing suicidal ideation. Younger age, higher levels of depression, social anxiety, and lower levels of self-esteem, ego-resiliency, and social support were found to be significantly correlated with suicidal ideation. In the final model, higher levels of depression and social anxiety were associated with an increased risk of suicidal ideation, while higher levels of self-esteem and social support were associated with a decreased risk of suicidal ideation. Although the independent effect was not significant, the interactions of ego-resiliency with both depression and social anxiety on suicidal ideation were significant. Higher levels of ego-resiliency acted as a buffer against suicidal ideation among those with higher levels of depression or social anxiety.

CONCLUSIONS

In addition to risk factors, this study revealed the underlying protective and moderating factors of suicidal ideation among medical students. Mental health programs focusing on enhancing ego-resiliency, self-esteem, and social support may contribute to suicide prevention in medical students.

Racial and ethnic differences in major depressive episode, severe role impairment, and mental health service utilization in U.S. adolescents

BACKGROUND/OBJECTIVES

This study aimed to examine racial and ethnic variations in national trends, past-year prevalence, determinants of major depressive episode (MDE), MDE-related role impairment and mental health (MH) services utilization in U.S. adolescents.

METHODS

Data was extracted from the National Survey on Drug Use and Health (NSDUH) from 2010 to 2018. A total of 137,671 nationally representative adolescents aged 12-17 were included in the study. Weighted temporal trends in the past-year prevalence of MDE, and MDE with severe role impairment were estimated both overall and by race and ethnicity. Weighted multivariate logistic regressions were conducted to assess racial/ethnic differences in determinants of MDE, MDE-related severe role impairment, and MH services utilization after adjusting for sociodemographic characteristics, family structure, substance use, activity participation, and problem-solving group engagement.

RESULTS

The prevalence of MDE and MDE with severe role impairment among U.S. adolescents has steadily increased, while MDE-related health services utilization remained low from 2010 to 2018. Racial and ethnic minority adolescents were more likely to experience an MDE, but less likely to use MH services compared to their White counterparts. Participating in school, family, community, or faith-based activities was significantly associated with lower MDE incidence. Problem-solving group engagement was associated with MH services utilization (all p-values < 0.05).

CONCLUSION

High prevalence of depression and low MH service utilization among U.S. adolescents remains a public health issue. Moreover, racial/ethnic disparities persist in MH and service utilization outcomes. Future research must investigate the burden and predictors of mental illness, and the factors influencing MH services utilization in diverse adolescent populations.

Contributions of universal school-based mental health promotion to the wellbeing of adolescents and preadolescents: a systematic review of educational interventions

Purpose

The study aims to determine the contributions of universal school-based educational programs to the current and future worldwide youth mental health condition.

Design/methodology/approach

A systematic search was conducted in accordance with the PRISMA 2020 guidelines. Academic education and health databases including ERIC, Education Database, APA PsycInfo, APA PsycArticles, Psychology Database, and PubMed were used. Characteristics and outcomes of educational interventions developed in school settings and education potential for mental health promotion were examined.

Findings

Universal school-based mental health educational programs positively affect preadolescents and adolescents. The study review provided further insight into educational programs' characteristics and identified two primary curricula foci: mental health education and development of resiliency traits and skills.

Originality/value

Research on mental health promotion using a pedagogical approach is rare as most studies focus on mental health symptomatology and psychotherapy techniques training.

Developmental Trajectory of Depressive Symptoms in Chinese College Students: Latent Classes and Gender Effect

Depressive symptoms are prevalent in Chinese college students, but little is known about the heterogeneity in the developmental trajectory of depressive symptoms in China. This study examined heterogeneity in the development of depressive symptoms and examined the effect of gender on the developmental trajectories over a 14-month period among Chinese college students (N = 1163, mean age 20.18, 80.31% female). Three different trajectories, moderate-increasing, high-stable and low-stable, captured the heterogeneity in the development of depressive symptoms. Gender showed significant influence on class membership. Relative to the moderate-increasing class, males emerged as significantly more likely than females to be found in the low-stable class (odds ratio (OR) = 2.73, 95% CI = (1.21, 6.13), p = 0.015) and the high-stable class (OR = 5.10, 95% CI = (1.12, 23.18), p = 0.035). The results provide additional evidence for the conclusion that the trajectories of depressive symptoms are heterogeneous with Chinese samples. Moreover, cultural difference should be paid more attention to when examining the effect of gender and other predictors of the trajectories of depressive symptoms.