Promoting adaptive emotion regulation and coping in adolescence: a school-based programme

A scoping review of school-based expressive writing implementation reporting practices: missed opportunities and new research directions

BACKGROUND

Expressive writing (EW) interventions are an effective, flexible, and cost-efficient option for mental health promotion, making them ideally suited for resource-limited school settings. However, the effectiveness of EW interventions varies greatly across studies, which may be partly explained by how EW interventions are implemented. As school-based EW interventions become increasingly popular and more widely used, rigorous reporting of implementation can help advance this emerging field by informing how variation in implementation across studies influences intervention outcomes.

PURPOSE

The purpose of this scoping review was to evaluate the implementation reporting practices of EW interventions in school settings as they can profoundly impact EW effectiveness.

METHODS

The present scoping review assessed the current state of fidelity of implementation (implementation) reporting in the school-based EW literature and identified areas where more rigorous reporting is needed. Out of an initial sample of 367 studies, 19 were eligible for inclusion in the review. Data were analyzed for critical issues and themes derived from Cargo et al.'s (2015) Checklist for Implementation (Ch-IMP).

RESULTS

Overall, the results of this scoping review indicate that researchers who implement EW in school settings have not consistently assessed key implementation domains such as dose received and fidelity.

CONCLUSIONS

To address this problem, the present review adds a unique contribution to the literature by identifying how rigorous reporting of implementation can strengthen the evidence base for school-based EW interventions. Specifically, researchers can support the use of EW interventions in schools through increased implementation reporting to better understand how variability in fidelity of implementation affects treatment outcomes.

Negative Emotional Reactivity and Somatic Symptoms during Adolescence Predict Adult Health and Wellbeing in Early and Middle Adulthood

Longitudinal research is lacking with respect to how negative emotional reactivity and somatic symptoms during adolescence set the stage for later health. The aim of this longitudinal study was to examine within-person associations between negative emotional reactivity and somatic symptoms during adolescence and their effects on health and wellbeing in adulthood. Participants (N = 1527; 48.3% female) were assessed annually at the age of 12 to 16 years and at the age of 35 and 45 years. Adolescents with frequent somatic symptoms reported higher reactivity. Individual differences in levels and changes of somatic symptoms and reactivity were independently associated with adult health and wellbeing decades later. The findings underscore the importance of considering how individual differences change during adolescent development.

Internet-based emotion-regulation training added to CBT in adolescents with depressive and anxiety disorders: A pilot randomized controlled trial to examine feasibility, acceptability, and preliminary effectiveness

BACKGROUND

Dysfunctional emotion regulation (ER) is associated with symptoms of depression and anxiety in adolescents. This pilot study aimed to examine the acceptability and feasibility of a guided internet-based emotion regulation training (ERT) added to cognitive behavioral therapy (CBT). Furthermore, we aimed to examine the feasibility of the randomized study design and to provide a first estimate of the effectiveness of CBT + ERT compared with CBT alone in adolescents with depressive or anxiety disorders.

METHODS

In a pilot randomized controlled trial (RCT) with a parallel group design, 39 patients (13-18 years) with depressive or anxiety disorder were assigned to CBT + ERT (n = 21) or CBT (n = 18). Assessments at baseline, three-months and six-months follow-up included treatment adherence, satisfaction, depressive symptoms, anxiety symptoms, and ER strategies.

RESULTS

Adherence to ERT was 66.5 %, and treatment satisfaction was adequate. 76.5 % of eligible patients participated in the study. Linear mixed-model analyses showed significantly reduced anxiety symptoms (p = .003), depressive symptoms (p = .017), and maladaptive ER (p = .014), and enhanced adaptive ER (p = .008) at six months follow-up in the CBT + ERT group compared to controls.

LIMITATIONS

The sample size was small, and results regarding effectiveness remain preliminary. Data-collection took place during COVID-19, which may have influenced the results.

CONCLUSIONS

Both the intervention and the study design were found to be feasible. In a larger RCT, however, improvement of recruitment strategy is necessary. Preliminary results indicate potential effectiveness in decreasing anxiety, depression, and emotion dysregulation in adolescents. The next step should be the development of an improved internet-based ERT and its evaluation in a larger RCT.

TRIAL REGISTRATION

Registered on January 14th, 2020 in The Netherlands Trial Register (NL8304).

Approaching or Decentering? Differential Neural Networks Underlying Experiential Emotion Regulation and Cognitive Defusion

The current study investigated the bottom-up experiential emotion regulation in comparison to the cognitiveve top down-approach of cognitive defusion. Rooted in an experiential- and client-centered psychotherapeutic approach, experiential emotion regulation involves an active, non-intervening, accepting, open and welcoming approach towards the bodily felt affective experience in a welcoming, compassionate way, expressed in ‘experiential awareness’ in a first phase, and its verbalization or ‘experiential expression’ in a second phase. Defusion refers to the ability to observe one’s thoughts and feelings in a detached manner. Nineteen healthy participants completed an emotion regulation task during fMRI scanning by processing highly arousing negative events by images. Both experiential emotion regulation and cognitive defusion resulted in higher negative emotion compared to a ‘watch’ control condition. On the neurophysiological level, experiential emotion regulation recruited brain areas that regulate attention towards affective- and somatosensorial experience such as the anterior cingulate cortex, the paracingulate gyrus, the inferior frontal gyrus, and the prefrontal pole, areas underlying multisensory information integration (e.g., angular gyrus), and linking body states to emotion recognition and awareness (e.g., postcentral gyrus). Experiential emotion regulation, relative to the control condition, also resulted in a higher interaction between the anterior insular cortex and left amygdala while participants experienced less negative emotion. Cognitive defusion decreased activation in the subcortical areas such as the brainstem, the thalamus, the amygdala, and the hippocampus. In contrast to cognitive defusion, experiential emotion regulation relative to demonstrated greater activation in the left angular gyrus, indicating more multisensory information integration. These findings provide insight into different and specific neural networks underlying psychotherapy-based experiential emotion regulation and cognitive defusion.

Components Related to Long-Term Effects in the Intra- and Interpersonal Domains: A Meta-Analysis of Universal School-Based Interventions

The aims of the present meta-analysis were to (1) examine long-term effects of universal secondary school-based interventions on a broad range of competencies and problems and (2) analyze which intervention components were related to stronger or weaker intervention effects at follow-up. Fifty-four studies of controlled evaluations (283 effect sizes) reporting on 52 unique interventions were included. Long-term intervention effects were significant but small; effect sizes ranged from .08 to .23 in the intrapersonal domain (i.e., subjective psychological functioning) and from .10 to .19 in the interpersonal domain (i.e., social functioning). Intervention components were generally related to effects on specific outcomes. Some components (e.g., group discussions) were even related to both stronger and weaker effects depending on the assessed outcome. Moreover, components associated with long-term effects differed from those associated with short-term effects. Our findings underscore the importance of carefully selecting components to foster long-term development on specific outcomes.

PROSPERO registration number: CRD42019137981.

Does the Weekly Practice of Recalling and Elaborating Episodes Raise Well-Being in University Students?

Increasing well-being is a prominent worldwide goal that can be achieved primarily through social support and environmental factors. However, in times of social distancing or isolation, it is important to also rely on self-managed activities. This study aimed to (a) test the effectiveness of a seven-week well-being intervention, in increasing need satisfaction, self-compassion, emotion regulation, and grateful disposition by curbing need frustration, self-derogation, and emotional suppression, and (b) examine the maintenance and long-term effects of the practices based on recall, elaboration, and writing. One hundred and twenty university students weekly recalled and elaborated for seven consecutive weeks on three recent episodes of gratitude, self-affirmation, goal setting, or meaningful things, according to the group to which they were assigned. Before the intervention, immediately after and one month later, they filled in questionnaires to assess need satisfaction/frustration, self-compassion/derogation, emotion regulation and grateful disposition. The results confirmed an increase in well-being and a decrease in ill-being for all groups (Cohen d for the significant differences ranging from 0.18 to 0.53). The effects were maintained one month later and even increased for self-compassion, self-derogation, need frustration, and emotional reappraisal. A follow-up assessment revealed that a third of the participants continued with the well-being practices. Implications and suggestions for future well-being interventions are discussed.

Parenting dimensions/styles and emotion dysregulation in childhood and adolescence: a systematic review and Meta-analysis

Emotion dysregulation is a transdiagnostic factor in the development of various mental and behavioral disorders, thus requiring ample evidence for prevention and intervention approaches. The aim of the current systematic review and meta-analysis was to investigate the association between parenting dimensions/styles and emotion dysregulation in childhood and adolescence. Following the PRISMA guidelines, the review was registered (PROSPERO CRD42021251672) and search terms were entered in Web of Science, Scopus, PsycINFO, and PubMed in May 2021. Articles needed to report on empirical studies that examined the association between parenting dimensions/styles and emotion dysregulation in children/adolescents with primary data, and be published in English in a peer-reviewed journal. Additionally, articles were excluded based on certain designs and focus on special populations. The narrative synthesis includes 30 articles, and of which 27 are included in the meta-analysis. An NHLBI tool with 14 items (e.g., validity) was utilized for assessing the quality of the included studies. General trends indicate that positive parenting (e.g., warmth, supportiveness) is negatively associated with emotion dysregulation, whilst negative parenting (e.g., psychological control, authoritarian) is positively associated. The meta-analysis reveals an overall small yet significant effect, however, the heterogeneity of the studies is moderate to high. A funnel plot demonstrated no evidence of publication bias. Limitations include the varying conceptualizations of emotion dysregulation, as well as a lacking focus on specific types of emotion. Although more research is needed, addressing factors such as culture, gender, and age, the review provides first indications of the significance of parenting dimensions/styles for emotion dysregulation.

Substance-related coping behaviours among youth during the early months of the COVID-19 pandemic

•

12% of youth in our sample used substances to cope with COVID-19-related changes.

•

Substance-related coping was more common among females than males in our sample.

•

Greater depression was associated with using substances to cope with COVID-19.

•

For females, psychosocial wellbeing may be protective of substance-related coping.

•

Secondary impacts of COVID-19 pandemic on youth substance use and mental health.

Objective

As impacts of the COVID-19 pandemic continue to unfold, research is needed to understand how school-aged youth are coping with COVID-19-related changes and disruptions to daily life. Among a sample of Canadian youth, our objective was to examine the mental health factors associated with using substances to cope with COVID-19-related changes, taking account of expected sex differences.

Methods

We used online data collected from 7150 students in the COMPASS study, during the early months of the COVID-19 pandemic (May–July 2020) in British Columbia, Ontario, and Quebec, Canada. We specified a sex-stratified, generalized linear mixed model to estimate the likelihood of engagement in substance-related coping behaviours, while testing for the effects of students’ mental health, individual characteristics, and school neighborhood characteristics.

Results

Twelve percent of students (13.4% of females, 9.9% of males) in our sample reported using cannabis, alcohol, cigarettes, and/or vaping to help cope with COVID-19-related changes. Regardless of sex, students with greater depressive symptoms were more likely to engage in substance-related coping (aOR_Female = 1.04, 95 %CI[1.01–1.07]; aOR_Male = 1.06, 95 %CI[1.013–1.11]). Among females, better psychosocial wellbeing was protective against engagement in substance related-coping (aOR = 0.96, 95 %CI[0.94–0.98]), controlling for current substance use.

Conclusions

Canadian school-aged youth with generally poor mental health may be more likely to have engaged in substance use to help cope with COVID-19-related changes during the first wave of the pandemic, and female youth may be at disproportionate risk of engaging in the behaviour. Ongoing evaluation of the impacts of COVID-19 on youth health is required.

Emotion profiles of university students engaging in non-suicidal self-injury: Association with functions of self-injury and other mental health concerns

We investigated emotion profiles among undergraduate students with lived experience of non-suicidal self-injury (NSSI) and their associations with different NSSI functions and other dysregulated behaviors, including risky drinking, symptoms of borderline personality disorder, eating disorders, anxiety, depression, and stress. A sample of 270 undergraduate students (84% female, M_age = 21.5 years) with a history of self-injury completed well-validated measures of self-injury, emotion regulation, alexithymia, coping strategies and of other dysregulated behaviors. A K-means cluster analysis was conducted to extract emotion profiles from the data. Analyses of variance were used to test associations between emotion profiles, demographic factors, functions of NSSI and comorbid dysregulated behaviors. A three-cluster solution was supported. Similar characteristics were presented regarding difficulties in emotion regulation and alexithymia between the considerate emotion difficulties and the passive moderate emotion difficulties groups, although they demonstrated different associations with the functions of NSSI and other dysregulating behaviors. This emphasizes the importance of investigating the type of coping strategies used during functional assessment to inform future treatment. The group reporting no emotion difficulties engaged in more adaptive coping strategies compared to the others. These emotion profiles and their association with NSSI functions could be used to develop more person-centered interventions for NSSI.

Adjustment of Couples to the Transition to Retirement: The Interplay of Intra- and Interpersonal Emotion Regulation in Daily Life

Background: Retirement is a central transition in late adulthood and requires adjustment. These processes not only affect the retired individuals but also their romantic partners. The aim of this study is to investigate the interplay of intrapersonal emotion regulation (rumination) with interpersonal regulation processes (disclosure quality). Furthermore, the associations of daily retirement-related disclosure with adjustment symptoms in disclosing and the listening partner will be investigated. It is expected that the effects of disclosure alter after providing the couples with a self-applied solitary written disclosure task in order to support their intrapersonal emotion regulation. Methods: In this dyadic online-diary study, 45 couples (N = 45) with one partner perceiving the adjustment to a recent retirement as challenging reported rumination, perceived disclosure quality (repetitive, focused on negative content, hard to follow, disclosing partner open for common/authentic), retirement-related disclosure, and ICD-11 adjustment symptoms preoccupation and failure to adapt were assessed at the end of the day over 14 days. In the middle of this assessment period, couples performed a modified online-expressive writing about their thoughts and feelings regarding the transition to retirement. Results: The double-intercept multilevel Actor-Partner Interdependence Models (APIM) reveal that on days with more daily rumination, the spouse perceived that disclosure of the retiree is more difficult to follow, more negative, and repetitive. In contrast, the retiree perceived less authenticity and openness to comments during disclosure on days when the spouse reports more rumination. Retirement-related disclosure showed no within-couple association with failure to adapt but actor effects on preoccupation. Moreover, a partner effect of disclosure of the retirees on the preoccupation of spouses could be observed. This contagious effect of the retiree disclosure, however, disappeared during the week after writing. Conclusion: Our results support the notion that disclosure processes are altered during maladaptive intrapersonal emotion regulation processes. This in turn seems to lead to less effective interpersonal regulation and contagious spilling over of symptoms. Supporting intrapersonal emotion regulation seems to have the potential to allow more favorable interpersonal regulation processes and to free interpersonal resources for an individual adjustment. This has implications for further planning of support for couples facing life transitions and aging-related changes.

Longitudinal associations of maternal stress and child stress with child body mass index trajectory

BACKGROUND

Although exposure to stress is common among children and their parents, longitudinal research on the effects of perceived stress on child obesity risk is lacking. This study examined the 3-year longitudinal associations of children and mothers' perceived stress with children's body mass index (BMI).

METHODS

A sample of 199 mothers and their children (8-12 years at baseline, 56% Hispanic) completed six semi-annual assessments across 3 years with questionnaire-based self-report measures of perceived stress and measured height/weight. Parallel process latent growth curve modelling specified regressions of latent intercept and slope of children's BMI on latent intercepts and slopes for mothers' and children's perceived stress.

RESULTS

Greater child self-reported perceived stress at baseline predicted greater increase in children's BMI across the six assessments whereas mother self-reported perceived stress at baseline was unrelated to change in child BMI. Baseline child BMI was unrelated to change in children or mothers' perceived stress across the six assessment waves.

CONCLUSION

Children's own perceptions of stress may play a larger contributing role in BMI progression during middle childhood than their mother's perceived stress levels. These findings underscore the importance of focusing on children's stress-coping strategies for promoting a healthy weight.

Behavioral profile, lifestyle and social skills in Portuguese adolescents

Background

Seventy percent of premature deaths in adults are due to behaviors initiated during adolescence. Therefore, it is essential to promote individual and social behaviors that educate adolescents in the ability to make healthy choices. Accordingly, the main goals of this study were to characterize Lifestyles and Social Skills, as well as identify homogeneous subgroups, in a sample of Portuguese adolescents.

Methods

A cross-sectional study was conducted, including 1008 adolescents attending the 7th to the 9th grades of five middle schools from the Tâmega and Sousa regions of Portugal, and using the My Lifestyle Questionnaire and the Social Skills Inventory. To establish a profile of the participants, a Cluster Analysis (K-means) was performed, and the Jaccard coefficient was used to assess the stability of the solution found.

Results

From the total sample, 556 adolescents with a mean age of 13.43 years (SD = 1.1) were included in the analysis. The majority of the sample presented a healthy lifestyle (72.26%) and 50.7% of the adolescents had a highly elaborated repertoire of Social Skills. Moreover, three clusters were found. Cluster 1 (n = 92) showed a less elaborate repertoire of Social Skills and was designated as the “Adjusted”. Cluster 2 (n = 115) comprised adolescents with a good repertoire of Social Skills and was named the “Sociable”. Cluster 3 (n = 258) was composed of adolescents with a highly elaborate repertoire of Social Skills and the best Lifestyle indicators and was named the “Healthy”.

Conclusions

The group of adolescents in the cluster called the “Sociable” needs to be included in health education and Social Skills programs. Nutrition and Monitored Safety behaviors reveal low values and, therefore, present a greater need for awareness, sensitization, and intervention in the school context. For this reason, the promotion of a healthy lifestyle should be part of the academic curriculum and transversal to all academic disciplines.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10355-1.

Components of School-Based Interventions Stimulating Students' Intrapersonal and Interpersonal Domains: A Meta-analysis

Many universal school-based interventions aim to stimulate students' intrapersonal (e.g., self-esteem) and interpersonal (e.g., school climate) domains. To improve our understanding of why some of these interventions yield stronger effects than others, we identified intervention components that are related to stronger or weaker intervention effects. We systematically searched four databases (i.e., PsycINFO, PubMed, ERIC, CENTRAL) for controlled evaluations of universal school-based interventions. In total, 104 included studies (529 included effect sizes) reported on 99 unique interventions. Interventions showed small positive effects on the intrapersonal (d = 0.19) and interpersonal (d = 0.15) domains. Focusing on self-awareness and problem solving, using more active learning approaches, and using more extensive interventions predicted stronger intervention effects on aspects of both domains. In contrast, efforts to improve emotion regulation, assertiveness, cognitive coping, and using group discussions predicted weaker intervention effects. Furthermore, commonly implemented components were not necessarily related to stronger intervention effects and components that were related to stronger effects were not necessarily often implemented. Our findings highlight the need to carefully select components for inclusion in interventions.PROSPERO Registration Number: CRD42019137981.

Sales training and ICT: a literature review

Purpose

The purpose of this paper is to identify in the specialized literature published in the past 20 years about sales training, some elements or key factors that could be applied to the use of information and communication technologies (ICT) as a support for the learning of the detection of business opportunities.

Design/methodology/approach

This is a study of a documentary nature in which a method of systematic literature review was applied to 132 studies published in journals indexed in Scopus and Scielo on sales training processes. The analysis of the data combined a process of categorization and frequencies statistical analysis.

Findings

The results highlight the role of ICT and specifically the use of mobile devices to support the strengthening of training in sales in terms of relationship, opportunity and flexibility in communication with the client, the construction of positive emotional environments and experiential/situated training.

Originality/value

The originality of this study lies in the extraction and interpretation of key factors focused on addressing a guiding question about the relationships between the use of ICT and sales training.

Adolescent Mental Health Program Components and Behavior Risk Reduction: A Meta-analysis

CONTEXT

Although adolescent mental health interventions are widely implemented, little consensus exists about elements comprising successful models.

OBJECTIVE

We aimed to identify effective program components of interventions to promote mental health and prevent mental disorders and risk behaviors during adolescence and to match these components across these key health outcomes to inform future multicomponent intervention development.

DATA SOURCES

A total of 14 600 records were identified, and 158 studies were included.

STUDY SELECTION

Studies included universally delivered psychosocial interventions administered to adolescents ages 10 to 19. We included studies published between 2000 and 2018, using PubMed, Medline, PsycINFO, Scopus, Embase, and Applied Social Sciences Index Abstracts databases. We included randomized controlled, cluster randomized controlled, factorial, and crossover trials. Outcomes included positive mental health, depressive and anxious symptomatology, violence perpetration and bullying, and alcohol and other substance use.

DATA EXTRACTION

Data were extracted by 3 researchers who identified core components and relevant outcomes. Interventions were separated by modality; data were analyzed by using a robust variance estimation meta-analysis model, and we estimated a series of single-predictor meta-regression models using random effects.

RESULTS

Universally delivered interventions can improve adolescent mental health and reduce risk behavior. Of 7 components with consistent signals of effectiveness, 3 had significant effects over multiple outcomes (interpersonal skills, emotional regulation, and alcohol and drug education).

LIMITATIONS

Most included studies were from high-income settings, limiting the applicability of these findings to low- and middle-income countries. Our sample included only trials.

CONCLUSIONS

Three program components emerged as consistently effective across different outcomes, providing a basis for developing future multioutcome intervention programs.

Brief report: A qualitative evidence synthesis of the psychological processes of school-based expressive writing interventions with adolescents

INTRODUCTION

Expressive writing interventions consist of brief writing sessions on thoughts and emotions and are known to yield positive benefits on adolescents' mental health. However, the psychological mechanisms explaining these effects are not clear.

METHOD

This review explored the psychological processes underlying school-based expressive writing interventions with adolescents. A thematic synthesis of qualitative research consisted of identifying, appraising and summarizing the qualitative evidence of eligible studies.

RESULTS

Only six of the 510 identified studies met the inclusion criteria of this review. Results provide some validation for cognitive-processing, emotion-regulation, and disinhibition as psychological mechanisms underlying school-based expressive writing with adolescents.

CONCLUSIONS

However, these conclusions are still preliminary because of the paucity of the qualitative evidence found, both in quantity and quality. We recommend that more rigorous and in-depth qualitative research be undertaken to: 1) explore adolescents' subjective experience about the expressive writing intervention, using in-depth individual interviews; 2) thoroughly assess the content of students' texts written during the intervention; and 3) document the process of expressive writing interventions through observational methods. The results of such investigations would support the development and implementation of school-based expressive writing-type of interventions adapted to adolescents.

'Boost Camp', a universal school-based transdiagnostic prevention program targeting adolescent emotion regulation; evaluating the effectiveness by a clustered RCT: a protocol paper

BACKGROUND

The transition from childhood into adolescence can be considered as a critical developmental period. Moreover, adolescence is associated with a decreased use of adaptive emotion regulation strategies and an increased use of maladaptive emotion regulation strategies increasing the risk of emotional problems. Targeting emotion regulation is therefore seen as an innovative prevention approach. The present study aims to evaluate the effectiveness of Boost camp, an innovative school-based prevention program targeting ER, on adolescents' emotion regulation skills and emotional wellbeing. Also secondary outcomes and possible moderators will be included.

METHODS

The aim is to reach 300 adolescents (16 class groups, 6 schools) in their first year of high school. A clustered Randomized Controlled Trial (RCT) with two conditions, intervention (n = 150) and control (n = 150), will be set up. Adolescents in the intervention condition will receive 14 lessons over the course of 2 days, followed by Booster sessions, and will be compared with adolescents in a non-intervention control group. The outcomes will be measured by self-report questionnaires at baseline, immediately after Boost camp, and at three and 6 months follow-up.

DISCUSSION

Data-collection is planned to be completed in May 2018. Data-analyses will be finished the end of 2018. The presented paper describes the Boost camp program and the clustered RCT design to evaluate its effectiveness. It is expected that Boost camp will have beneficial effects. If found effective, Boost camp will have the potential to increase adolescent's ER and well-being, and reduce the risk to become adults in need. The trials is registered on the 13th of June 2017 in ISRCTN registry [ISRCTN68235634].

Emotionsregulation

Zusammenfassung. Positive Emotionen und gute Fertigkeiten zur Emotionsregulation sind für eine gesunde Entwicklung eines Kindes zentral. Nur wenn es Kindern gelingt, angemessene Emotionsregulationsstrategien zu entwickeln, werden sie gut in ihre soziale Umwelt integriert sein. Der Qualität der Emotionsregulation kommt eine wesentliche Funktion für die Entstehung psychischer Störungen im Kindesalter zu. Längsschnittstudien können einen bedeutsamen Zusammenhang zwischen einer unangemessenen Emotionsregulation und der Herausbildung von Angst- und depressiven Störungen auf der einen und aggressiven Verhalten auf der anderen Seite belegen.

Letting Oneself Go Isn't Enough: Cognitively Oriented Expressive Writing Reduces Preadolescent Peer Problems

Peer problems are a stressor for many early adolescents, and simple cost-effective tools for managing peer stress are needed. Expressive writing (EW) may be one such tool. With a sample of middle school children aged 12-14 years (n = 119; 53% males), this research evaluates whether cognitively oriented expressive writing (CEW), which focuses more on psychological self-distancing, improves personal well-being better than traditional EW, which focuses more on emotional disclosure. CEW-compared with EW-slightly enhanced long-term social adjustment for the entire sample, and increased positive affect for those early adolescents that reported more peer problems at baseline. These findings suggest that structured writing instructions with early adolescents may be key to improvements.

Assessing Fit Between Evidence-Based Psychotherapies for Youth Depression and Real-Life Coping in Early Adolescence

The modest efficacy of psychological interventions for youth depression, including evidence-based psychotherapies (EBPs), suggests a question: Do the therapy components match the coping strategies youths find helpful when dealing with depressed mood? Answering this question may help strengthen treatments. We asked 105 middle schoolers across a range of depression symptom levels to identify the coping strategies they used when they felt sad (habitual responses) and those that made them feel better (perceived-effective responses). Habitual and perceived-effective responses were coded for resemblance to EBPs, and each youth's habitual responses were coded for their match to the youth's perceived-effective responses. Most perceived-effective responses (92.6%) matched EBP components (most frequent: Behavioral Activation); however, 65.0% of the EBP components did not match any youth's habitual or perceived-effective responses. Youths at higher depression symptom levels were significantly more likely than low-symptom youths to report (a) habitual responses that did not match EBP components, (b) habitual responses that did not match their own perceived-effective responses, and (c) perceiving no effective response. The higher their depression symptom level, the less likely youths were to use strategies identified by researchers and perceived by themselves as effective, and the less likely they were to identify any perceived-effective coping strategy. The findings suggest a need to (a) determine which EBP components do in fact enhance youth coping, (b) design the most effective ways to help youths master those effective components, and

Identifying attentional deployment tactics in older adults' written narratives about emotionally upsetting events

Essays about distressing events written by 58 older adults on three occasions (n = 174) were coded to identify how older adults responded when confronting an emotionally upsetting event. Participants limited the experience of negative emotion by transitioning from negative to positive aspects of the event within a writing session, and across sessions, switched writing topics and moved from writing about past events to current problems. The use of attentional deployment tactics was associated with lower negative affect. This study confirms results found in quantitative studies and uncovers new processes that promote emotion regulation.

Processing coping methods in expressive essays about stressful experiences: Predictors of health benefit

This study distinguished constructive (e.g. planning/problem-solving) and unconstructive (e.g. worry) processing in expressive essays and their impact on depressive symptoms, healthcare visits, and physical symptoms. Affect labeling, achievement orientation, and insight utilization were examined as mediators. Essays from 43 medical students were coded; mediators were identified through linguistic text analysis. Outcomes were assessed at baseline and 3 months. Constructive processing predicted declining depressive symptoms (β = −.33, p < .05) and healthcare visits (β = −.61, p < .01). Unconstructive processing predicted increasing healthcare visits (β = .42, p < .05). Higher affect labeling mediated the effect of constructive processing, and lower achievement orientation mediated the effect of unconstructive processing.

Self-esteem mediates the effect of the parent–adolescent relationship on depression

There is a trend of rapid growth in both the level and occurrence of depression when people reach adolescence. The present study aimed to investigate the impact of the parent–adolescent relationship on depression in adolescents, and mainly focused on the confirmation of the mediator role of self-esteem. A total of 364 senior middle school students accomplished the Parent–Adolescent Relationship Scale, Rosenberg Self-Esteem Scale, and Zung Self-Rating Depression Scale. The results suggested that both parent–adolescent relationship and self-esteem were significantly correlated with depression. Structural equation modeling indicated that self-esteem partially mediated the relationship between parent–adolescent relationship and depression.

Vision for improvement: Expressive writing as an intervention for people with Stargardt's disease, a rare eye disease

This study implemented and evaluated the effectiveness of an expressive writing intervention among patients with Stargardt's disease, a rare disease due to macular degeneration. Participants were randomly assigned to either an expressive writing intervention or a neutral writing condition. Participants completed measures at three time points: baseline, 3 weeks, and 6 weeks post-intervention. Psychological health outcomes improved at the 3-week follow-up for the intervention condition compared to control. Self-reported physical health improved at the 6-week follow-up in the intervention condition compared to control. These results suggest that expressive writing may be an effective, practical, and low-cost intervention for those with Stargardt's disease.

Mental health and the school environment: secondary schools, promotion and pathways to care

PURPOSE OF REVIEW

Addressing youth mental health in secondary schools has received greater attention globally in the past decade. It is essential that educators, mental health experts, researchers, and other related service providers understand the most current research findings to inform policy making, and identify priority areas for the development of future interventions and research strategies. This review describes literature during the past year on school-based mental health programs addressing mental health promotion, prevention, early identification and intervention/treatment.

RECENT FINDINGS

In contrast to the abundance of school-based mental health programs, the evidence of program effectiveness, safety and cost-effectiveness in this area is somewhat insufficient, mostly due to the lack of rigorous research designs, the heterogeneity of school environments, and the complexities of interventions that require multisector collaboration.

SUMMARY

Although the opportunity in school mental health is substantial, much yet needs to be done to develop and evaluate interventions that can be proven to be effective, safe and cost-effective. Mental health literacy may be an appropriate start that will help to set the foundation for mental health promotion, prevention and intervention.

Encouraging acceptance of ambivalence using the expressive writing paradigm

OBJECTIVES

Ambivalence is regarded as a key target for psychotherapeutic change. This study aimed to examine the effectiveness of a brief expressive writing intervention for reducing distress about goal ambivalence.

DESIGN

A sample of 40 undergraduate students were randomly allocated to an experimental 'expressive writing' condition or a control condition.

METHOD

Participants rated their ambivalence about the 10 most important goals they were currently pursuing and rated how distressing they found these feelings of ambivalence. Participants then completed three short expressive writing sessions on consecutive days. Participants in the experimental condition participants wrote about their deepest thoughts and feelings relating to their ambivalence, and participants in the control condition wrote about how they had spent their time that day or week.

RESULTS

When controlling for baseline distress about ambivalence, there was a significant effect of writing condition on distress about ambivalence at follow-up; individuals who wrote about their ambivalence experienced a significant reduction in their level of distress about ambivalence.

CONCLUSION

It was concluded that expressive writing might represent an analogue of therapeutic approaches to encourage acceptance of ambivalence.