Stress and psychopathology in children and adolescents: is there evidence of specificity?

Reduced discrimination between signals of danger and safety but not overgeneralization is linked to exposure to childhood adversity in healthy adults

Childhood adversity is a strong predictor of developing psychopathological conditions. Multiple theories on the mechanisms underlying this association have been suggested which, however, differ in the operationalization of 'exposure.' Altered (threat) learning mechanisms represent central mechanisms by which environmental inputs shape emotional and cognitive processes and ultimately behavior. 1402 healthy participants underwent a fear conditioning paradigm (acquisition training, generalization), while acquiring skin conductance responses (SCRs) and ratings (arousal, valence, and contingency). Childhood adversity was operationalized as (1) dichotomization, and following (2) the specificity model, (3) the cumulative risk model, and (4) the dimensional model. Individuals exposed to childhood adversity showed blunted physiological reactivity in SCRs, but not ratings, and reduced CS+/CS- discrimination during both phases, mainly driven by attenuated CS+ responding. The latter was evident across different operationalizations of 'exposure' following the different theories. None of the theories tested showed clear explanatory superiority. Notably, a remarkably different pattern of increased responding to the CS- is reported in the literature for anxiety patients, suggesting that individuals exposed to childhood adversity may represent a specific sub-sample. We highlight that theories linking childhood adversity to (vulnerability to) psychopathology need refinement.

Fostering learning engagement: the impact of different interpersonal relationships from the perspective of positive youth development

Learning engagement is a crucial factor affecting the quality of learning and holds significant value in promoting student development and enhancing teaching quality. By using time-lagged data from four schools and considering intentional self-regulation, this study integrates three types of relationships (parent-child, teacher-student, and peer relationships) into the same research framework to examine their impacts on learning engagement and the underlying mechanisms among high school students. The findings reveal that parent-child, teacher-student, and peer relationships all significantly positively affect high school students' learning engagement. Intentional self-regulation plays a partial mediation effect between parent-child relationship and learning engagement, teacher-student relationship and learning engagement, along with peer relationship and learning engagement. The unique effect of peer relationship on learning engagement is significantly greater than that of teacher-student relationship but is not significantly greater than that of parent-child relationship. To better create a supportive synergy for enhancing students' learning engagement, it is suggested that families and schools provide consistent learning support within their capabilities.

The pernicious role of stress on intergenerational continuity of psychopathology

Development and Psychopathology has been a premier resource for understanding stressful childhood experiences and the intergenerational continuity of psychopathology. Building on that tradition, we examined the unique and joint influences of maternal stress on children's effortful control (age 7) and externalizing behavior (age 11) as transmitted via genetics, the prenatal environment, and the postnatal environment. The sample included N = 561 adopted children and their biological and adoptive parents. Path models identified a direct effect of biological mother life stress on children's effortful control (β = -.08) and an indirect effect of her life stress on child externalizing behavior via effortful control (β = .52), but no main or indirect effects of biological parent psychopathology, prenatal stress, or adoptive mother adverse childhood experiences (ACES). Adoptive mother ACES amplified the association between biological mother life stress and child effortful control (β = -.08), externalizing behavior (β = 1.41), and the indirect effect via effortful control, strengthening associations when adoptive mothers reported average or high ACES during their own childhoods. Results suggest that novel study designs are needed to enhance the understanding of how life stress gets "under the skin" to affect psychopathology in the offspring of adults who have experienced stress.

Concentration of critical events over the life course and life satisfaction later in life

Critical events create turning points, disrupt individuals' life courses, and affect wellbeing. Periods of life densely populated with critical events may translate into an acute resource drain, affecting long-term wellbeing more strongly than if the same events were sparsely distributed. We investigate how the co-occurrence of critical events and their concentration in time influence life satisfaction in later life. To do so, we construct a novel indicator, the Concentration Index, based not only on the number but also on the time lag between occurrences. Using retrospective information on critical events in family, work, health, and residential trajectories in Switzerland, we show that the higher the concentration in time of critical events is, the stronger their negative long-term relation to wellbeing, net of sociodemographic characteristics, the total number of events ever experienced, and the time since the last event. Furthermore, relevant gender and social origin differences emerged with a stronger negative association with wellbeing among men and respondents from low socioeconomic backgrounds. Our work clearly shows that simply counting the number of events gives only a partial and potentially inaccurate measure of the complexity of the life course and its relationship with quality of life. Not only how many events experienced matter but also the spacing between them.

How adverse childhood experiences get under the skin: A systematic review, integration and methodological discussion on threat and reward learning mechanisms

Adverse childhood experiences (ACEs) are a major risk factor for the development of multiple psychopathological conditions, but the mechanisms underlying this link are poorly understood. Associative learning encompasses key mechanisms through which individuals learn to link important environmental inputs to emotional and behavioral responses. ACEs may impact the normative maturation of associative learning processes, resulting in their enduring maladaptive expression manifesting in psychopathology. In this review, we lay out a systematic and methodological overview and integration of the available evidence of the proposed association between ACEs and threat and reward learning processes. We summarize results from a systematic literature search (following PRISMA guidelines) which yielded a total of 81 articles (threat: n=38, reward: n=43). Across the threat and reward learning fields, behaviorally, we observed a converging pattern of aberrant learning in individuals with a history of ACEs, independent of other sample characteristics, specific ACE types, and outcome measures. Specifically, blunted threat learning was reflected in reduced discrimination between threat and safety cues, primarily driven by diminished responding to conditioned threat cues. Furthermore, attenuated reward learning manifested in reduced accuracy and learning rate in tasks involving acquisition of reward contingencies. Importantly, this pattern emerged despite substantial heterogeneity in ACE assessment and operationalization across both fields. We conclude that blunted threat and reward learning may represent a mechanistic route by which ACEs may become physiologically and neurobiologically embedded and ultimately confer greater risk for psychopathology. In closing, we discuss potentially fruitful future directions for the research field, including methodological and ACE assessment considerations.

Assessing family relations in borderline personality disorder: A relational approach

The aims of the current study are to describe the basic family relationships, parental bonding patterns, and dyadic adjustment of families with offspring diagnosed with borderline personality disorder (BPD) and to explore the correlations between these variables related to family relations and BPD symptomatology. The sample consisted of 194 participants, including parents from the control (N = 76) and clinical group (N = 76), and patients with BPD (N = 42). All progenitors completed a measure of family relations, parental bonding, and dyadic adjustment. Patients completed a measure of parental bonding and borderline symptomatology. The results showed significant differences between both groups in marital and parental functioning, marital satisfaction, dyadic adjustment, and care. Correlations among family variables and BPD symptomatology were also found. In summary, findings underscore the significance of comprehending the complexity of family relationships in BPD while advocating for a relational perspective when examining the family dynamics.

The effect of age and resilience on the dose-response function between the number of adversity factors and subjective well-being

Background

Encountering challenges and stress heightens the vulnerability to mental disorders and diminishes well-being. This study explores the impact of psychological resilience in the context of adverse events, considering age-related variations in its influence on well-being.

Methods

A total of 442 participants (male vs. female =48% vs. 52%) with a mean age of 41.79 ± 16.99 years were collected and completed the following questionnaires Brief Betrayal Trauma Survey (BBTS), Brief Resilience Scale (BRS), Peace of Mind (PoM), The World Health Organization Quality of Life-BREF (WHOQOL-BREF), and Social Support Questionnaire (SSQ). They all underwent structural and resting-state functional magnetic resonance imaging (MRI) scans.

Results

Participants were categorized based on adversity levels: 34.39% faced one, 26.24% none, and 19.91, 9.50, and 8.14% encountered two, three, and four adversities, respectively. This categorization helps assess the impact on participants' experiences. As adversity factors increased, PoM decreased. Controlling for age improved PoM model fit (ΔR2 = 0.123, p < 0.001). Adversity factors and age explained 14.6% of PoM variance (df = 2, F = 37.638, p < 0.001). PoM decreased with more adversity and increased with higher age.

Conclusion

The study found most participants faced at least one adversity. Adversity negatively affected PoM scores, while resilience acted as a protective factor. Resilience plays a crucial role in buffering the impact of adversities on well-being. Among those with high adversity, higher resilience correlated with stronger DMN-right frontal pole connectivity. Brain volume showed no significant differences, but the quality of life and social support varied between subgroups, with no differences in personal demographic and biophysical features.

Stressors and coping strategies among secondary school male students in Abha City, Saudi Arabia

Background

Stress is a biological process in which exposure to stressors is associated with bad health effects, decreased ability of disease management, and a higher likelihood for disease-related complications and comorbidities. Stress has been considered the main factor in the etiology of many diseases such as diabetes mellitus, cardiac diseases, and body aches for centuries. Students meet many stressful situations such as the need for success, academic demands, homesickness, and lack of social support. Coping with stress can be a leading cause in preventing psychological distress and a serious illness.

Methods

A correlational cross-sectional approach was applied to the current research. The research targeted all secondary school male students in Abha city. A multistage cluster sample was applied by selecting schools and students from the Directorate of Education in Abha. Self-administered questionnaire sheets were distributed to students in their classes. The questionnaire covered students' sociodemographic data such as age, grades, parents' education and work, living conditions, and comorbidities. Stressors to which the students were exposed were also enumerated with the degree of stress for each. Stress was assessed using the Holmes-Rahe Stress Inventory for youth. Coping skills were measured using the abbreviated version of the COPE Inventory.

Results

The study included 324 students whose ages ranged from 15 to 20 years old with a mean age of 17 ± 0.9 years old. Approximately 33% of the students were in first grade; 44.4% of the students had no or minimal level of stress while major stress was recorded among 26.5% of the students. In total, 77.8% of the students had moderate coping and none had high coping ability.

Conclusion

The study revealed that more than half of the students had significant levels of stress and one out of each four had major stress. The most common stressors were due to the school environment and future planning. Young age, low socioeconomic status, parents' separation, and having chronic health problems were the most important determinants of stress among the students.

First Onset in Adulthood of Mental Disorders: Exposure to War vs. Non-war Childhood Adversities: A National Study

Background

There is evidence that some childhood trauma increases the risk of the first onset of mental disorders and for the first time into adulthood. There are no studies that assessed whether exposure to war has this delayed long-term effect.

Objectives

To fill this gap by investigating the comparative roles of war and non-war trauma on the first onset of adulthood mood and anxiety disorders.

Methods

A nationally representative sample of 2,857 Lebanese was assessed using the World Health Organization Composite International Diagnostic Interview 3.0. with the onset of exposure to trauma and of first onset of mood and anxiety disorders.

Results

Non-war childhood traumata especially those belonging to family malfunctioning continue to exert their effect for the first time well beyond their occurrence as they were the most universal predictors for adult onset of both mood and anxiety disorders. War trauma during childhood predicted mood anxiety and mood (anxiety only in males) only below age 18 y. war childhood trauma predicts the first onset of mood and anxiety disorders before age 18 y in females, but only anxiety in males.

Conclusion

Childhood traumata are not equal in predicting the first onset of mood and anxiety disorders into adulthood. Family malfunctioning looks to carry the longest such risk and war more of shorter immediate effects. This might change though with re-exposure to war in adulthood which might unravel dormant vulnerability.

Parental mental disorders and offspring schizotypy in middle childhood: an intergenerational record linkage study

PURPOSE

To investigate relationships between distinct schizotypy risk profiles in childhood and the full spectrum of parental mental disorders.

METHODS

Participants were 22,137 children drawn from the New South Wales Child Development Study, for whom profiles of risk for schizophrenia-spectrum disorders in middle childhood (age ~ 11 years) were derived in a previous study. A series of multinomial logistic regression analyses examined the likelihood of child membership in one of three schizotypy profiles (true schizotypy, introverted schizotypy, and affective schizotypy) relative to the children showing no risk, according to maternal and paternal diagnoses of seven types of mental disorders.

RESULTS

All types of parental mental disorders were associated with membership in all childhood schizotypy profiles. Children in the true schizotypy group were more than twice as likely as children in the no risk group to have a parent with any type of mental disorder (unadjusted odds ratio [OR] = 2.27, 95% confidence intervals [CI] = 2.01-2.56); those in the affective (OR = 1.54, 95% CI = 1.42-1.67) and introverted schizotypy profiles (OR = 1.39, 95% CI = 1.29-1.51) were also more likely to have been exposed to any parental mental disorder, relative to children showing no risk.

CONCLUSION

Childhood schizotypy risk profiles appear not to be related specifically to familial liability for schizophrenia-spectrum disorders; this is consistent with a model where liability for psychopathology is largely general rather than specific to particular diagnostic categories.

The role of mild stressors in children's cognition and inflammation: positive and negative impacts depend on timing of exposure

Although the impact of stressful life events (SLEs) on mental health is well-established, the research on the impact of such stressors on cognitive outcomes has produced mixed results. Arguably, the timing and severity of exposure may play a key role. In this study, we shed light on the relationship between timing of exposure to relatively minor SLEs and cognitive ability in children, while taking into account the role of a plausible biological mediator: inflammation. Using data from the Avon Longitudinal Study of Parents and Children, a general population birth cohort, we explored the role of relatively minor SLEs, experienced during two crucial developmental stages: up to transition to school (1-4.5 years) and up to transition to puberty (5.5-8.5 years). We then tested if they may impact differently on inflammatory markers (serum C-reactive protein [CRP] and interleukin 6 [IL-6]) at age 9 and general intelligence, measured with the Wechsler Abbreviated Scale of Intelligence at age 15. Data (n = 4,525) were analyzed using path analysis while controlling for covariates. We found that when relatively minor stressful events were experienced up to transition to school they were significantly associated with higher IQ at age 15, whereas when experienced up to transition to puberty they were significantly associated with higher levels of IL-6 at age 9. Results were robust to adjustment for relevant covariates, including IQ at age 8. Mild stressors in childhood may result in positive (i.e., improved cognition) or negative (i.e., inflammation) outcomes depending on the timing of exposure.

A stable and replicable neural signature of lifespan adversity in the adult brain

Environmental adversities constitute potent risk factors for psychiatric disorders. Evidence suggests the brain adapts to adversity, possibly in an adversity-type and region-specific manner. However, the long-term effects of adversity on brain structure and the association of individual neurobiological heterogeneity with behavior have yet to be elucidated. Here we estimated normative models of structural brain development based on a lifespan adversity profile in a longitudinal at-risk cohort aged 25 years (n = 169). This revealed widespread morphometric changes in the brain, with partially adversity-specific features. This pattern was replicated at the age of 33 years (n = 114) and in an independent sample at 22 years (n = 115). At the individual level, greater volume contractions relative to the model were predictive of future anxiety. We show a stable neurobiological signature of adversity that persists into adulthood and emphasize the importance of considering individual-level rather than group-level predictions to explain emerging psychopathology.

Early Social Adversity, Altered Brain Functional Connectivity, and Mental Health

Early adverse environmental exposures during brain development are widespread risk factors for the onset of severe mental disorders and strong and consistent predictors of stress-related mental and physical illness and reduced life expectancy. Current evidence suggests that early negative experiences alter plasticity processes during developmentally sensitive time windows and affect the regular functional interaction of cortical and subcortical neural networks. This, in turn, may promote a maladapted development with negative consequences on the mental and physical health of exposed individuals. In this review, we discuss the role of functional magnetic resonance imaging-based functional connectivity phenotypes as potential biomarker candidates for the consequences of early environmental exposures-including but not limited to-childhood maltreatment. We take an expanded concept of developmentally relevant adverse experiences from infancy over childhood to adolescence as our starting point and focus our review of functional connectivity studies on a selected subset of functional magnetic resonance imaging-based phenotypes, including connectivity in the limbic and within the frontoparietal as well as default mode networks, for which we believe there is sufficient converging evidence for a more detailed discussion in a developmental context. Furthermore, we address specific methodological challenges and current knowledge gaps that complicate the interpretation of early stress effects on functional connectivity and deserve particular attention in future studies. Finally, we highlight the forthcoming prospects and challenges of this research area with regard to establishing functional connectivity measures as validated biomarkers for brain developmental processes and individual risk stratification and as target phenotypes for mechanism-based interventions.

Adaptation of the Coping With Stress Course for Black Adolescents in Low-Income Communities: Examples of Surface Structure and Deep Structure Cultural Adaptations

Black adolescents in low-income communities are at increased risk of developing mental health problems due to the impact of cumulative poverty-related stressors and racial discrimination, yet Black youth have relatively low rates of mental health service utilization, resulting in significant unmet need. The Coping With Stress (CWS) Course is an evidence-based, cognitive behavioral intervention that has been shown to reduce the incidence of anxiety, mood, and conduct problems among predominantly White samples, as well as Asian and Latinx youth. In the past 25 years since the CWS Course was introduced, Black adolescents have either been severely underrepresented or conspicuously absent from program evaluation research on the CWS Course, with few exceptions. The purpose of this article is threefold: (1) to justify the need for cultural adaptations to the CWS Course for Black adolescents from low-income communities, (2) to describe the scientific basis for the specific surface structure and deep structure modifications made to the culturally adapted version of the CWS Course, known as Resilient In spite of Stressful Events or RISE, and (3) to illustrate the deep structure adaptations with a vignette drawn from implementation of the RISE program with Black adolescents in a low-income, urban community.

Specific Pathways from Parental Distress Reactions to Adolescent Depressive Symptoms: The Mediating Role of Youths' Reactions to Negative Life Events

The current multimethod longitudinal study examines how parents' distress reactions to adolescents' negative emotions may shape youths' own perceptions of negative life events and subsequent increases in depressive symptomology. Ninety adolescents (41 girls, 49 boys, average age = 16.5 years old) and their parents were assessed over three timepoints. We found that greater parent-reported distress reactions to adolescents' emotions predicted subsequent increase in youths' own self-reported negative reactions to stressful experiences over a two-week period, which in turn predicted steeper increases in youth-reported depressive symptoms across this same two-week period. Moreover, youths' negative reactions mediated the relation between parent emotion socialization and increases in adolescent depressive symptoms. These findings support the use of interventions that simultaneously target parent and child distress to prevent the onset of adolescent depression.

Effectiveness of school-based brief cognitive behavioral therapy with mindfulness in improving the mental health of adolescents in a Japanese school setting: A preliminary study

Background

Emotional regulation is important for adolescents’ adaptive development. Preventive interventions for anxiety and depression are necessary for reducing the development of disorders later in life, and emotional regulation is a potentially relevant factor.

Objective

We investigated the effects of a mindfulness-based psychological education and prevention program [the Mindfulness and Awareness Program (MAP)] on the mental health of junior high school students in Japan.

Methods

Our MAP primarily focused on mindfulness meditation to improve emotional regulation, thereby reducing depression and anxiety. The MAP comprised eight sessions (20 min each) administered by a school counselor in a school setting. All participants (N = 349) were 12–13-year-old adolescents from nine classes in two Japanese schools. The program was provided to the intervention group, wherein students were educated on emotional expression, emotional cognition, and emotional regulation. The control group received regular school counseling services.

Results

Compared with the control group, the intervention group showed significant improvement in emotional regulation and a decrease in depression and generalized anxiety. The effect was greater at the follow-up assessment than at the immediate post-intervention assessment, and greater in female students.

Conclusion

Our mental health prevention program exhibited efficacy in reducing depression and anxiety and enhancing emotional regulation in early adolescence. Further, it appeared to be more effective for female adolescents.

Genetic Variants Associated With Resilience in Human and Animal Studies

Resilience is broadly defined as the ability to maintain or regain functioning in the face of adversity and is influenced by both environmental and genetic factors. The identification of specific genetic factors and their biological pathways underpinning resilient functioning can help in the identification of common key factors, but heterogeneities in the operationalisation of resilience have hampered advances. We conducted a systematic review of genetic variants associated with resilience to enable the identification of general resilience mechanisms. We adopted broad inclusion criteria for the definition of resilience to capture both human and animal model studies, which use a wide range of resilience definitions and measure very different outcomes. Analyzing 158 studies, we found 71 candidate genes associated with resilience. OPRM1 (Opioid receptor mu 1), NPY (neuropeptide Y), CACNA1C (calcium voltage-gated channel subunit alpha1 C), DCC (deleted in colorectal carcinoma), and FKBP5 (FKBP prolyl isomerase 5) had both animal and human variants associated with resilience, supporting the idea of shared biological pathways. Further, for OPRM1, OXTR (oxytocin receptor), CRHR1 (corticotropin-releasing hormone receptor 1), COMT (catechol-O-methyltransferase), BDNF (brain-derived neurotrophic factor), APOE (apolipoprotein E), and SLC6A4 (solute carrier family 6 member 4), the same allele was associated with resilience across divergent resilience definitions, which suggests these genes may therefore provide a starting point for further research examining commonality in resilience pathways.

Regional Internet Access and Mental Stress Among University Students: A Representative Nationwide Study of China

Background

The Internet changed the lives of average citizens in the early part of the twenty-first century, and it has now become an essential part of daily life. Many studies reported that accessibility of Internet use is associated with mental health. However, previous studies examining this association were confined to local and community subpopulations and limited at the individual level, which increases the potential bias from the selection effect at a different level. Regional variables would be a stable estimate of people's socioeconomic and cultural environments and how these variables affect mental health needed to be studied. The objective of this study was to evaluate the association between regional Internet access, and mental stress among university students.

Methods

Participants were 11,954 students, who were identified through a multistage survey sampling process conducted in 50 Chinese universities. Regional Internet access was retrieved from a national database, and mental stress was measured using the Perceived Stress Scale (Chinese Version) (CPSS). Both unadjusted and adjusted methods were considered in the analyses.

Results

More than one-third 36.9% (95% CI: 24.4–49.5%) of university students in this study suffered from severe mental stress (SMR). The multilevel logistic regression model found that university students studied in low-level universities had 2.52 (95% C.I. 1.17 to 6.37) times the prevalence of SMR than those in high-level universities. Compared with small cities, students in a large city had a lower prevalence of SMR (OR 0.25; 95%C.I. 0.06 to 0.77). Most importantly, regional Internet access was negatively associated with students' SMR (OR 0.25; 95%C.I. 0.08 to 0.76).

Conclusions

This study indicated that regional Internet access and other environmental factors including city size and type of universities contribute to students' mental health. The findings underscore that efforts to control excessive mental stress among students in China should pay greater attention to environmental determinants of stress and particularly to improve internet access.

The Association between Stressful Life Events and Emotional and Behavioral Problems in Children 0-7 Years Old: The CIKEO Study

Background: Stressful life events (SLEs) are recognized risk factors for emotional and behavioral problems, but the association is understudied among young children. Our aim was to examine the association between exposure to SLEs and emotional and behavioral problems in young children up to 7 years old. Methods: We analyzed baseline data from 959 children (mean age = 3.3 years; SD = 1.9; 47.5% girls) in the CIKEO study, a community-based longitudinal study in the Netherlands. Linear regression was used to assess the associations between the total as well as the individual exposure to SLEs experienced in the past 12 months, and emotional and behavioral problems assessed by CBCL 1.5-5. Interactions of SLEs and child age, sex, ethnic background, and socioeconomic status were explored. Results: Higher total exposure to SLEs, as indicated by the number of SLEs, was significantly associated with higher CBCL total, internalizing and externalizing problem scores (p for trend < 0.05). The results did not differ by child age, sex, ethnic background, or family SES. Six out of the 12 SLEs explored were independently associated with greater CBCL total/externalizing/internalizing scores (p < 0.05). Conclusions: Exposure to SLEs is associated with higher levels of emotional and behavioral problems in young children, and the impact of SLEs may vary depending on the types of events. Stressful life events might be a useful target for interventions to improve emotional and behavioral well-being among young children.

Does the Temporal Pattern of Moving to a Higher-Quality Neighborhood Across a 5-Year Period Predict Psychological Distress Among Adolescents? Results From a Federal Housing Experiment

Using data from the Moving to Opportunity (MTO) experiment (1994-2002), this study examined how a multidimensional measure of neighborhood quality over time influenced adolescent psychological distress, using instrumental variable (IV) analysis. Neighborhood quality was operationalized with the independently validated 19-indicator Child Opportunity Index (COI), linked to MTO family addresses over 4-7 years. We examined whether being randomized to receive a housing subsidy (versus remaining in public housing) predicted neighborhood quality across time. Using IV analysis, we tested whether experimentally induced differences in COI across time predicted psychological distress on the Kessler Screening Scale for Psychological Distress (n = 2,829; mean β = -0.04 points (standard deviation, 1.12)). The MTO voucher treatment improved neighborhood quality for children as compared with in-place controls. A 1-standard-deviation change in COI since baseline predicted a 0.32-point lower psychological distress score for girls (β = -0.32, 95% confidence interval: -0.61, -0.03). Results were comparable but less precisely estimated when neighborhood quality was operationalized as simply average post-random-assignment COI (β = -0.36, 95% confidence interval: -0.74, 0.02). Effect estimates based on a COI excluding poverty and on the most recent COI measure were slightly larger than other operationalizations of neighborhood quality. Improving a multidimensional measure of neighborhood quality led to reductions in low-income girls' psychological distress, and this was estimated with high internal validity using IV methods.

A systematic review of transdiagnostic risk and protective factors for general and specific psychopathology in young people

A large body of research has emerged over the last decade examining empirical models of general and specific psychopathology, which take into account comorbidity among psychiatric disorders and enable investigation of risk and protective factors that are common across disorders. This systematic review presents findings from studies of empirical models of psychopathology and transdiagnostic risk and protective factors for psychopathology among young people (10-24 years). PsycInfo, Medline and EMBASE were searched from inception to November 2020, and 41 studies were identified that examined at least one risk or protective factor in relation to broad, empirically derived, psychopathology outcomes. Results revealed several biological (executive functioning deficits, earlier pubertal timing, genetic risk for ADHD and schizophrenia, reduced gray matter volume), socio-environmental (stressful life events, maternal depression) and psychological (low effortful control, high neuroticism, negative affectivity) transdiagnostic risk factors for broad psychopathology outcomes, including general psychopathology, internalising and externalising. Methodological complexities are discussed and recommendations for future studies of empirical models of psychopathology are presented. These results contribute to a growing body of support for transdiagnostic approaches to prevention and intervention for psychiatric disorders and highlight several promising avenues for future research.

The psychological effects of event cancellation in Olympic-level swimmers: preliminary findings and mental health screening recommendations

BACKGROUND

Mental health screening of elite athletes is not routinely practiced following the cancellation of an athletic event. Though sporting event cancellation has negative career and training impacts on elite athletes, little is known about its psychological impact. To determine the extent to which sporting event cancellation might warrant psychological screening practices in elite athletics, this study evaluated elite-level swimmers' response to the cancellation of the 2020 Olympic Games through psychological assessment and qualitative interviewing.

METHODS

A cross-sectional study design was implemented. Online psychological assessment included self-report scales to measure anxiety, burnout, psychological strain, and optimism/pessimism. Follow-up semi-structured telehealth interviews were conducted to assess appraisals of and coping responses to the cancellation.

RESULTS

Of the 14 participants assessed for mental health symptoms, 12 were available for interview procedures. Results (mean ± SD) indicated 'very high' psychological strain (22.71 ± 4.83) and 'mild' anxiety (6.29 ± 4.87). All swimmers exhibited levels of psychological strain that warranted clinical evaluation per established cut-off scores. Thematic content analysis of interviews generated four themes: pre-cancellation evaluations, primary appraisals, coping responses, and coping outcomes. Most swimmers exhibited maladaptive coping (75%); however, adaptative coping was as prevalent (92%), particularly through use of support networks. Most swimmers achieved positive coping outcomes (75%) and maintained strong 2021 Olympicqualifying confidence (93%). In contrast, swimmers with poor coping outcomes (25%) employed more frequent maladaptive coping strategies and exhibited higher psychological distress.

CONCLUSIONS

Findings urge sports medicine clinicians to implement psychological screening protocols in elite athletes following the cancellation of a major sporting event to attend to symptoms of psychological distress and to direct appropriate psychological intervention.

What makes adolescents psychologically distressed? Life events as risk factors for depression and suicide

Adolescence is a vulnerable period for psychological distress. This study aimed to comprehensively investigate the distribution of major stress-causing factors and their correlates in a large population of adolescents. A computerized self-report questionnaire was completed by 291,110 participating adolescents over a 4-year period using a cross-sectional study design. The questionnaire included items assessing demographic variables, major stressors, severity of perceived stress, and mental health outcomes such as depressed mood, suicidal ideation, and attempts. Among the major stressors, schoolwork/career was the most predominant (54.7%). However, the odds ratios for depressed mood and suicidal ideation were the highest in the stressor of conflict with peers (OR = 1.97 for depressed mood and OR = 2.00 for suicidal ideation), followed by family circumstances (OR = 1.77 and 1.94 for depressed mood and suicidal ideation, respectively). Conversely, schoolwork/career presented significantly lower odds ratios of 0.87 and 0.87 for depressed mood and suicidal ideation, respectively. This study provides important information on psychological distress related to adolescents' mental health. Although school/career was the most prevalent source of psychological stress, the odds ratios for negative health outcomes of adolescents were higher in interpersonal problems such as conflicts with parents and peers and family circumstances. The present findings might help parents and clinicians understand the psychological distress of adolescents and improve their mental health.

Contextual risks and psychosocial outcomes among rural African American emerging adults: A latent profile analysis

African American emerging adults face unique contextual risks that place them at heightened risk for poor psychosocial outcomes. The purpose of this study was to identify profiles of contextual risks among rural African American emerging adults and determine how risk profiles relate to psychosocial outcomes. Our representative sample included 667 fifth graders who live in the rural South and were followed from preadolescence into emerging adulthood. Contextual risks were assessed at ages 19-21 years via six indicators: perceived stress, daily stress, community disadvantage, parent-child conflict, racial discrimination, and childhood trauma. Four psychosocial variables were also assessed at ages 19-21 years: self-regulation, racial identity, parent support, and friend support. Psychosocial outcomes were assessed at age 25 years: education, substance use, future orientation, depressive symptoms, and externalizing behaviors. Latent profile analysis results indicated that the sample could be characterized by three patterns of contextual risk: low contextual risk, high contextual risk, and high contextual risk-childhood trauma. Risk profiles were associated with psychosocial outcomes, with the childhood trauma and high-risk profiles faring worse than the low-risk profile. Further, childhood trauma was particularly predictive of worse outcomes for emerging adults. Findings highlight the need for research and prevention programs that mitigate the effects of contextual risks on psychosocial outcomes for African American emerging adults in rural areas.

Characterizing the impact of adversity, abuse, and neglect on adolescent amygdala resting-state functional connectivity

Characterizing typologies of childhood adversity may inform the development of risk profiles and corresponding interventions aimed at mitigating its lifelong consequences. A neurobiological grounding of these typologies requires systematic comparisons of neural structure and function among individuals with different exposure histories. Using seed-to-whole brain analyses, this study examined associations between childhood adversity and amygdala resting-state functional connectivity (rs-fc) in adolescents aged 11–19 years across three independent studies (N = 223; 127 adversity group) in both general and dimensional models of adversity (comparing abuse and neglect). In a general model, adversity was associated with altered amygdala rs-fc with clusters within the left anterior lateral prefrontal cortex. In a dimensional model, abuse was associated with altered amygdala rs-fc within the orbitofrontal cortex, dorsal precuneus, posterior cingulate cortex, and dorsal anterior cingulate cortex/anterior mid-cingulate cortex, as well as within the dorsal attention, visual, and somatomotor networks. Neglect was associated with altered amygdala rs-fc with the hippocampus, supplementary motor cortex, temporoparietal junction, and regions within the dorsal attention network. Both general and dimensional models revealed unique regions, potentially reflecting pathways by which distinct histories of adversity may influence adolescent behavior, cognition, and psychopathology.

Stressful Events and Temperament Change during Early and Middle Adolescence: The TRAILS Study

This project investigates how stressful events are related to deviations from normative temperament development during adolescence. Temperament traits were assessed at ages 11 and 16 years. Life–event data was captured using an interview (total n = 1197). Normative changes were found in all traits. A linear trend was found between the experience of stressful events and temperament development. Adolescents exposed to stressful events showed smaller decreases in fear and shyness, stronger decreases in effortful control and affiliation and smaller increases in high intensity pleasure. Exposure to stressful events was related to increases in frustration instead of decreases. Our results show that whereas normative development is mostly in the direction of maturation, adolescents who experienced stressful events showed less maturation of their temperament. Copyright © 2011 John Wiley & Sons, Ltd.

Mental Health Needs of Refugee Children in Specialized Early Education and Care Programs in Germany

Refugee children are at risk to develop mental health problems, which have rarely been investigated in educational contexts. We conducted three studies in childcare programs for refugees in Germany. Children's behavior was assessed by educators on site (n = 84) and online (n = 50) using a two-stage-cluster sampling and on site (n = 107) using complete samples. In Study 1 and 2, children showed elevated attention problems ranging from medium to large effect sizes, r = 0.2 and r = 0.5, respectively, and aggressive behavior problems ranging from small to large effect sizes, r = 0.1 and r = 0.5, respectively, when compared to norm data. In Study 3, children showed elevated peer-problems, r = 0.5. Future research needs to investigate whether these problems are a consequence of adapting to a novel context or a precursor of a psychopathology caused by risk factors in the context of forced displacement.

The relationship between stressful events, emotion dysregulation, and anxiety symptoms among youth: longitudinal support for stress causation but not stress generation

INTRODUCTION

There is a clear bi-directional link between stressful events and depressive symptoms in adolescence, but the directionality of this link for anxiety symptoms remains underexamined. We critically evaluate the longitudinal relationship between stressors and anxiety among youth. Specifically, we examine whether stressors predict anxiety symptoms over a 1.5-year period (stress causation), and whether anxiety symptoms predict stressors over this period (stress generation). We examine potential influencing factors, including stressor type (independent vs. dependent) and emotion dysregulation (nonacceptance; goal-directed difficulty).

METHODS

Social, separation, and physical anxiety symptoms, and frequency and stressor type, were assessed every 3 months for 1.5 years among community youth (n = 528, ages 8-17). Baseline emotion dysregulation was assessed. Time-lagged analyses evaluated the bi-directional relationship of stress and anxiety over time, controlling for previous anxiety and depression.

RESULTS

Interpersonal stressors predicted subsequent physical and social anxiety symptoms, but anxiety did not predict subsequent stressors. Both nonacceptance and goal-directed difficulties predicted subsequent anxiety symptoms and stressors, but did not moderate the relationship.

CONCLUSION

The findings supported the stress causation model for youth anxiety, but not the stress generation model. Nonacceptance and goal-directed difficulty predicted greater subsequent anxiety symptoms and stressors. We discuss implications for prevention and intervention.

Too Much of a Good Thing: Social Capital and Academic Stress in South Korea

In intense academic environments such as in South Korea, students experience extreme levels of academic stress. This stress peaks as students prepare for the college entrance exam in the final year of high school. Stress is associated with a host of negative outcomes, and academic stress is the leading cause of suicidal ideation among youth in South Korea. Research suggests that in high-stress contexts such as this, social capital can improve academic success and mental health, while reducing risky or deviant behaviors. However, this research has predominantly focused on Western contexts. Because of the unique intensity of educational pursuits and intense investment in education by parents, South Korea provides a compelling case for research on the effects of family and school social capital on youth academic stress. Using data from the Korea Youth Panel Survey (N = 2753), we find that particular components of family and school social capital can both reduce and exacerbate academic stress. While measures of closeness and connection to parents reduced academic stress, school social capital had a limited impact on academic stress. Furthermore, there may be a limit to the effectiveness of social capital to help with academic stress before it becomes too much of a good thing.

Transdiagnostic Risk and Protective Factors for Psychopathology in Young People: Systematic Review Protocol

Background

Mental and substance use disorders are among the leading causes of burden of disease worldwide, with risk of onset peaking between the ages of 13 and 24 years. Comorbidity is also common among young people and complicates research, diagnosis and assessment, and clinical decision making. There is increasing support for empirically derived models of psychopathology that overcome issues of comorbidity and provide a transdiagnostic framework for investigating the specificity and generality of risk and protective factors for psychopathology.

Objective

This systematic review aims to identify transdiagnostic risk and protective factors for psychopathology in young people by synthesizing and evaluating findings from research investigating empirically based models of psychopathology.

Methods

Searches will be conducted in Medline, EMBASE, and PsycINFO databases. Reference lists of selected articles will also be hand searched for other relevant publications. All studies will be screened against eligibility criteria designed to identify studies that examined empirical models of psychopathology in relation to risk and/or protective factors in young people with a mean age between 10 and 24 years. Study quality will be assessed using the Joanna Briggs Institute Critical Appraisal Checklists for Cohort Studies and Analytical Cross-Sectional Studies. Findings will be summarized in a narrative synthesis, and a meta-analysis will be conducted if sufficient data are available.

Results

This review is ongoing. At the time of submission, full-text screening was completed, and hand searching of selected articles was underway. Results are expected to be completed by the end of 2020.

Conclusions

This protocol is for a systematic review of evidence for transdiagnostic risk and protective factors associated with empirically based models of psychopathology in young people. To our knowledge, the critical synthesis of this evidence will be the first to date and will provide a better understanding of the factors that contribute to the onset and maintenance of psychopathology in young people. Insights drawn from the review will provide critical new knowledge to improve the targeting of interventions to prevent or reduce mental health problems.

Trial Registration

This systematic review is registered with PROSPERO (CRD42020161368) and is available via Open Science Framework.

International Registered Report Identifier (IRRID)

DERR1-10.2196/19779

The Differential Role of Coping, Physical Activity, and Mindfulness in College Student Adjustment

Research has examined the function of stress management techniques, including coping, physical activity, and mindfulness on college students’ adjustment. The present study examined the differential contributions of three stress management techniques to students’ maladaptation (perceived stress, depression, anxiety, and loneliness) and adaptation (self-esteem). Undergraduate students (N = 1185) responded to an online survey. Hierarchical linear regression results indicated that all three stress management techniques – coping, physical activity, and mindfulness – were related to the five outcomes as predicted. Higher levels of disengagement coping strategies were related to higher perceived stress, anxiety, and depression. Components of mindfulness emerged as a strong predictor of adaptation.

Longitudinal Assessment of Mental Health Disorders and Comorbidities Across 4 Decades Among Participants in the Dunedin Birth Cohort Study

IMPORTANCE

Mental health professionals typically encounter patients at 1 point in patients' lives. This cross-sectional window understandably fosters focus on the current presenting diagnosis. Research programs, treatment protocols, specialist clinics, and specialist journals are oriented to presenting diagnoses, on the assumption that diagnosis informs about causes and prognosis. This study tests an alternative hypothesis: people with mental disorders experience many different kinds of disorders across diagnostic families, when followed for 4 decades.

OBJECTIVE

To describe mental disorder life histories across the first half of the life course.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study involved participants born in New Zealand from 1972 to 1973 who were enrolled in the population-representative Dunedin Study. Participants were observed from birth to age 45 years (until April 2019). Data were analyzed from May 2019 to January 2020.

MAIN OUTCOMES AND MEASURES

Diagnosed impairing disorders were assessed 9 times from ages 11 to 45 years. Brain function was assessed through neurocognitive examinations conducted at age 3 years, neuropsychological testing during childhood and adulthood, and midlife neuroimaging-based brain age.

RESULTS

Of 1037 original participants (535 male [51.6%]), 1013 had mental health data available. The proportions of participants meeting the criteria for a mental disorder were as follows: 35% (346 of 975) at ages 11 to 15 years, 50% (473 of 941) at age 18 years, 51% (489 of 961) at age 21 years, 48% (472 of 977) at age 26 years, 46% (444 of 969) at age 32 years, 45% (429 of 955) at age 38 years, and 44% (407 of 927) at age 45 years. The onset of the disorder occurred by adolescence for 59% of participants (600 of 1013), eventually affecting 86% of the cohort (869 of 1013) by midlife. By age 45 years, 85% of participants (737 of 869) with a disorder had accumulated comorbid diagnoses. Participants with adolescent-onset disorders subsequently presented with disorders at more past-year assessments (r = 0.71; 95% CI, 0.68 to 0.74; P < .001) and met the criteria for more diverse disorders (r = 0.64; 95% CI, 0.60 to 0.67; P < .001). Confirmatory factor analysis summarizing mental disorder life histories across 4 decades identified a general factor of psychopathology, the p-factor. Longitudinal analyses showed that high p-factor scores (indicating extensive mental disorder life histories) were antedated by poor neurocognitive functioning at age 3 years (r = -0.18; 95% CI, -0.24 to -0.12; P < .001), were accompanied by childhood-to-adulthood cognitive decline (r = -0.11; 95% CI, -0.17 to -0.04; P < .001), and were associated with older brain age at midlife (r = 0.14; 95% CI, 0.07 to 0.20; P < .001).

CONCLUSIONS AND RELEVANCE

These findings suggest that mental disorder life histories shift among different successive disorders. Data from the present study, alongside nationwide data from Danish health registers, inform a life-course perspective on mental disorders. This perspective cautions against overreliance on diagnosis-specific research and clinical protocols.

Life Events Predicting the First Onset of Adolescent Direct Self-Injurious Behavior-A Prospective Multicenter Study

PURPOSE

Self-injurious behavior is a frequent phenomenon in adolescence. The present study prospectively examined life events as risk factors for the first onset of direct self-injurious behavior (D-SIB) in the Saving and Empowering Young Lives in Europe school-based multicenter sample.

METHODS

Longitudinal assessments with an interval of 1 year were performed within a sample of 1,933 adolescents (51.47% females; mean age 14.84 ± .9 years) from 10 European countries and Israel.

RESULTS

The number of life events during the past 6 months predicted the first onset of D-SIB in the following year. Gender neither predicted the onset of D-SIB nor moderated the association with life events. Moreover, analyses of individual events identified a range of mainly interpersonal events within both family and peer group as proximal risk factors for first episode D-SIB.

CONCLUSIONS

The results support the critical role of interpersonal life events in the development of D-SIB for both genders and refine the conceptualization of proximal risk factors in terms of accumulated stressors and interpersonal events.

Adverse experiences in early childhood and their longitudinal impact on later behavioral problems of children living in poverty

BACKGROUND

Adverse childhood experiences (ACEs) are an identified risk factor for the social and emotional development of children. What is less known is the long-term effects of ACEs when poverty and ACEs coincide.

OBJECTIVE

Using longitudinal cohort-panel data, we examined whether exposure to ACEs by the age of three among poor children would longitudinally result in behavioral problems at ages three, five, nine, and 15, after controlling for mothers' socioeconomic status and their children's characteristics.

PARTICIPANTS AND SETTING

We used a subsample of 2750 children and their parents living in urban poverty from the Fragile Families and Child Wellbeing study.

METHODS

Logistic regression modeling was used to obtain adjusted odds ratios of ACE categories predicting behavioral problems after accounting for family socioeconomic position.

RESULTS

Our findings indicate that experiencing ACEs in early childhood was significantly associated with later behavioral outcomes from childhood to adolescence. Exposure to multiple ACEs before the age of three was significantly associated with the top-risk behavior group at age five; the odd ratios were 2.0 (CI = 1.3-3.1) and 2.9 (CI = 1.8-4.6) for two ACEs and three or more ACEs, respectively. At both ages nine and 15, children experiencing two or more ACEs had 1.9 to 3.2 times higher odds to demonstrate more the top 10th percentile of behavioral problems. Among covariates, mothers' race and education, and children's gender and temperament were identified as significant factors to determine behavior problems.

CONCLUSIONS

The findings support policies and programs for families with children who have experienced economic disadvantages and early childhood adversity.

Childhood adversity and adolescent psychopathology: evidence for mediation in a national longitudinal cohort study

BACKGROUND

Childhood adversity is a well-established risk factor for psychopathology; however, many who experience adversity do not go on to develop psychopathology. Poor self-concept and poor parental support are known risk factors for adolescent psychopathology, which may account for some of this mechanism.

AIMS

To investigate candidate mediators in the relationship between childhood adversity and psychopathology.

METHOD

We used data from the age 9 and 13 waves of the child-cohort of the Growing Up in Ireland study. We undertook mediation analysis by path decomposition of the relationship between childhood adversity and psychopathology (internalising and externalising problems) at age 13 and persistent psychopathology. Candidate mediators were self-concept, parent-child relationship and hobby participation at age 9.

RESULTS

Childhood adversity was reported by 28.2% of participants, and was significantly associated with internalising and externalising problems. Parent-child conflict mediated the relationship between childhood adversity and both age 13 and persistent psychopathology, accounting for 52.4% of the relationship between childhood adversity and persistent externalising problems (indirect odds ratio, 1.30; 95% CI 1.19-1.43) and 19.2% for persistent internalising problems (indirect odds ratio, 1.24; 95% CI 1.15-1.34). There was a small mediating effect of self-concept. Hobby participation and positive parent-child relationship did not mediate these relationships.

CONCLUSIONS

Parent-child conflict explains almost half the relationship between childhood adversity and persisting externalising problems in adolescence, and a fifth of the relationship with persisting internalising problems. This suggests parent-child conflict is a good target for interventions in childhood to prevent adolescent psychopathology.

DECLARATION OF INTEREST

None.

Linking Stressful Experiences and Psychological Problems: The Role of Self-Esteem

Stressful experiences have repeatedly been related to psychological problems. The current study extends previous work on stress and psychological problems by examining the link between stressful experiences and both internalizing (INT) and externalizing (EXT) problems. Additionally, individual differences are investigated by testing the moderating role of self-esteem. Questionnaire data of 750 adolescents aged 12–18 were collected and analyzed using multiple regression analyses. Analyses were controlled for sex and socioeconomic status. Results indicated that adolescents who report more stressful experiences are more likely to experience both INT and EXT problems, and these relationships were stronger for adolescents with low self-esteem. Post hoc analyses (e.g., different thresholds for determining stressful experiences) support the robustness of our findings. The findings on self-esteem emphasize the importance of taking individual differences into account in the relation between stressful experiences and psychological problems. The results can be seen as a next step in cross-sectional research.

The Longitudinal Relations between Dimensions of Community Violence Exposure and Developmental Outcomes among Adolescent Ethnic Minority Males

OBJECTIVE

Community violence exposure is multi-dimensional, yet the majority of studies examining the relation of exposure and developmental outcomes employ measures that collapse a wide range of experiences into a global summed scale. Building on research conducted in child maltreatment indicating that the impact of exposure varies as a function of the nature of maltreatment, the present study examines the contribution of dimensions of exposure to community violence (i.e., type - hearing about violence, witnessing violence, victimization - and relationship to perpetrator) on three areas of adolescent functioning: depression, aggression, and attention problems.

METHOD

Longitudinal data was gathered from a sample of racial/ethnic minority male adolescents (N = 246) living in impoverished urban neighborhoods. Multiple regression analyses assessed the relation between dimensions and outcomes cross-sectionally and longitudinally.

RESULTS

In line with findings from maltreatment, dimensions of violence exposure mattered differentially for developmental outcomes when examined concurrently. However, when relations are examined longitudinally, controlling for initial levels of functioning, the majority these relations disappear.

CONCLUSIONS

Assessing exposure to specific dimensions of exposure might improve understanding of adolescent concurrent, but not later functioning. Findings underscore the value of prospective data when examining the impact of dimensions of community violence exposure on functioning.

Schools as Vehicles to Assess Experiences, Improve Outcomes, and Effect Social Change

Schools are important settings that can be utilized to yield a positive impact on youth and the many issues our society faces. In this Presidential Address, I identify key issues and directions for the field, advocating that we need to expand our ecological focus, improve school climate, and collaborate with schools to effect change. To illustrate these key themes, findings from four projects with k-12 youth and educators in the United States are described, and these projects have the following foci: protective factors for youth exposed to violence, teacher-directed violence as part of an APA Task Force, school climate and neighborhood factors in relation to academic outcomes, and school transitions for students with disabilities. Challenges and future directions to build upon community psychology theory, research, practice, and policy are discussed.

Adolescent clinical populations and associations between trauma and behavioral and emotional problems

OBJECTIVE

Trauma exposure is common during childhood and adolescence and is associated with youth emotional and behavioral problems. The present study adds to the current literature on trauma exposure among adolescent clinical populations by examining the association between trauma exposure and adolescent self-report of emotional and behavioral problems broadly, including internalizing and externalizing symptoms, in addition to the trauma-specific symptoms of posttraumatic stress disorder (PTSD).

METHOD

This study included 94 female (64%) and male (36%) adolescents, ages 13-19, representing 4 clinical populations: those seeking inpatient psychiatry, outpatient psychiatry, residential substance abuse, and outpatient medical services. Adolescents self-reported trauma history and internalizing, externalizing, and PTSD symptoms.

RESULTS

Most adolescents reported experiencing at least 1 traumatic event (83%; M = 2.28, SD = 1.83). Multiple regression analyses controlling for age, race/ethnicity, gender, and treatment setting indicated a greater number of types of trauma are associated with externalizing symptoms (β = .31, p < .01) and PTSD symptoms (β = .35, p < .01).

CONCLUSION

Trauma is a common experience among adolescents, particularly those presenting for behavioral health services, making trauma-informed care essential in these service delivery settings. Treatment that addresses adolescent risk behaviors and prevents recurrent trauma may be particularly important given the negative impact of multiple traumatic events on developing adolescents. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Relationship Between Posttraumatic Cognitive Change, Posttraumatic Stress Disorder, and Posttraumatic Growth Among Chinese Adolescents After the Yancheng Tornado: The Mediating Effect of Rumination

The aim of this study was to explore the different cognitive processes involved in the development of posttraumatic stress disorders (PTSDs) and posttraumatic growth (PTG). One year after the Yancheng tornado, 455 middle school students were assessed to study how posttraumatic cognitive change (PCC) influenced PTSD and PTG among traumatized Chinese adolescents through the role of rumination. The results indicated that intrusive rumination partly mediated the relationship between PCC and PTSD, and deliberate rumination partly mediated the relationship between PCC and PTSD and completely mediated the relationship between PCC and PTG. These results suggest that the cognitive processes of PTSD and PTG are different. Furthermore, the study also suggests that PTSD and PTG can coexist in individuals. This study may offer some suggestions for clinical practice after traumatic events.

Childhood aggression: A synthesis of reviews and meta-analyses to reveal patterns and opportunities for prevention and intervention strategies

This study provides a synthesis of meta-analyses and systematic reviews on non-pharmacological treatments for childhood aggression. Treatments referred to universal prevention, selective prevention, indicated prevention, or intervention (Mrazek and Haggerty, 1994). Seventy-two meta-analyses and systematic reviews met the inclusion criteria. We describe their characteristics, effect sizes across types of treatments, and the effects of various moderators. For universal and selective prevention, effects were mostly absent or small; for indicated prevention and interventions, effects were mostly small or medium. Only two moderators had a positive effect on treatment effectiveness, namely pre-test levels of aggression and parental involvement. These results identified similarities between indicated prevention and intervention treatments, on the one hand, and universal prevention and selective prevention, on the other. Our findings suggest that research distinguishing between targets of treatments (i.e., factors associated with childhood aggression vs. present aggressive behaviors) would be promising. Moreover, to further increase effectiveness of treatments for childhood aggression, individual differences warrant scientific attention.