Daily-Life Social Experiences as a Potential Mediator of the Relationship Between Parenting and Psychopathology in Adolescence

Readdressing the Ongoing Challenge of Missing Data in Youth Ecological Momentary Assessment Studies: Meta-Analysis Update

BACKGROUND

Ecological momentary assessment (EMA) is pivotal in longitudinal health research in youth, but potential bias associated with nonparticipation, omitted reports, or dropout threatens its clinical validity. Previous meta-analytic evidence is inconsistent regarding specific determinants of missing data.

OBJECTIVE

This meta-analysis aimed to update and expand upon previous research by examining key participation metrics-acceptance, compliance, and retention-in youth EMA studies. In addition, it sought to identify potential moderators among sample and design characteristics, with the goal of better understanding and mitigating the impact of missing data.

METHODS

We used a bibliographic database search to identify EMA studies involving children and adolescents published from 2001 to November 2023. Eligible studies used mobile-delivered EMA protocols in samples with an average age up to 18 years. We conducted separate meta-analyses for acceptance, compliance, and retention rates, and performed meta-regressions to address sample and design characteristics. Furthermore, we extracted and pooled sample-level effect sizes related to correlates of response compliance. Risk of publication bias was assessed using funnel plots, regression tests, and sensitivity analyses targeting inflated compliance rates.

RESULTS

We identified 285 samples, including 17,441 participants aged 5 to 17.96 years (mean age 14.22, SD 2.24 years; mean percentage of female participants 55.7%). Pooled estimates were 67.27% (k=88, 95% CI 62.39-71.96) for acceptance, 71.97% (k=216, 95% CI 69.83-74.11) for compliance, and 96.57% (k=169, 95% CI 95.42-97.56) for retention. Despite overall poor moderation of participation metrics, acceptance rates decreased as the number of EMA items increased (log-transformed b=-0.115, SE 0.036; 95% CI -0.185 to -0.045; P=.001; R2=19.98), compliance rates declined by 0.8% per year of publication (SE 0.25, 95% CI -1.3 to -0.3; P=.002; R2=4.17), and retention rates dropped with increasing study duration (log-transformed b=-0.061, SE 0.015; 95% CI -0.091 to 0.032; P<.001; R2=10.06). The benefits of monetary incentives on response compliance diminished as the proportion of female participants increased (b=-0.002, SE 0.001; 95% CI -0.003 to -0.001; P=.003; R2=9.47). Within-sample analyses showed a small but significant effect indicating higher compliance in girls compared to boys (k=25; g=0.18; 95% CI 0.06-0.31; P=.003), but no significant age-related effects were found (k=14; z score=0.05; 95% CI -0.01 to 0.16).

CONCLUSIONS

Despite a 5-fold increase in included effect sizes compared to the initial review, the variability in rates of missing data that one can expect based on specific sample and design characteristics remains substantial. The inconsistency in identifying robust moderators highlights the need for greater attention to missing data and its impact on study results. To eradicate any health-related bias in EMA studies, researchers should collectively increase transparent reporting practices, intensify primary methodological research, and involve participants' perspectives on missing data.

TRIAL REGISTRATION

PROSPERO CRD42022376948; https://www.crd.york.ac.uk/PROSPERO/view/CRD42022376948.

Examining Psychosis Risk in Sexual Minority Youth: Increased Exposure to and Differential Impact of the Social Envirome in Early Adolescence

BACKGROUND AND HYPOTHESES

Sexual minority populations have a higher prevalence of psychotic experiences (PE), possibly due to differential experiences within the social envirome in its positive (eg, social support, parenting) and negative aspects (eg, adverse life events, bullying). This study hypothesized that (1) sexual minority adolescents experience more PE, (2) are more exposed to harmful aspects of the social envirome, and (3) may display differential sensitivity to certain aspects of the social envirome.

STUDY DESIGN

Data from 678 adolescents (mean age 15.6 years) were analyzed. Psychotic experiences were assessed using the Prodromal Questionnaire 16 (PQ-16). Aspects of the social envirome (childhood adversity, bullying, parenting style, and social support) were evaluated using different questionnaires.

STUDY RESULTS

The odds ratio of having sexual minority status (SMS) was 1.98 (95 CI%, 1.02-3.84) for participants with PE (PQ-16 ≥ 6) compared to participants without. Significant associations were found between SMS and more adverse childhood experiences (95% CI, 0.11-3.51) and parenting psychological control (95% CI, 0.11-0.53), and less parenting autonomy support (95% CI, -0.37 to -0.01). There were also significant differential effects: adverse childhood experiences were associated with PE in heterosexuals but not in sexual minorities (95% CI, -0.34 to -0.03), while less social support was associated with more PE in heterosexuals but less PE in sexual minorities (95% CI, 0.06-0.39).

CONCLUSIONS

Sexual minority status is associated with a higher prevalence of PE, greater exposure to harmful factors within the social envirome, and differential effects on sexual minority and heterosexual individuals. These results emphasize the need for a fine-grained analysis of the envirome to understand the increased risk for PE in sexual minorities.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Impacts of COVID-19 quarantine and isolation on adolescent social functioning

This review discusses research conducted globally between March 2020 and March 2023 examining the impact of the COVID-19 pandemic on adolescent social functioning, including their lifestyle, extracurricular activities, family environment, peer environment, and social skills. Research highlights the widespread impact, with largely negative effects. However, a handful of studies support improved quality of relationships for some young people. Study findings underscore the importance of technology for fostering social communication and connectedness during periods of isolation and quarantine. Most studies specifically examining social skills were cross-sectional and conducted in clinical populations, such as autistic or socially anxious youth. As such, it is critical that ongoing research examines the long-term social impacts of the COVID-19 pandemic, and ways to promote meaningful social connectedness via virtual interactions.

Ecological and Convergent Validity of Experimentally and Dynamically Assessed Capacity for Social Contingency Detection Using the Perceptual Crossing Experiment in Adolescence

The Perceptual Crossing Experiment (PCE) captures the capacity for social contingency detection using real-time social interaction dynamics but has not been externally validated. We tested ecological and convergent validity of the PCE in a sample of 208 adolescents from the general population, aged 11 to 19 years. We expected associations between PCE performance and (a) quantity and quality of social interaction in daily life, using Experience Sampling Methodology (ESM; ecological validity) and (b) self-reported social skills using a questionnaire (convergent validity). We also expected PCE performance to better explain variance in ESM social measures than self-reported social skills. Multilevel analyses showed that only self-reported social skills were positively associated with social experience of company in daily life. These initial results do not support ecological and convergent validity of the PCE. However, fueled by novel insights regarding the complexity of capturing social dynamics, we identified promising methodological advances for future validation efforts.

Lest We Forget the Parent in the Parent-Adolescent Dance!

Adolescence is a developmental stage with rapid, and dynamic, biological and social changes in an individual. These changes add to the vulnerabilities for mental health morbidity. Adolescents today live and grow at the center of a layered, globalized, hyper-connected world where proximate and distal environments constantly influence each other. Parenting is part of the most proximate of the environmental layers, and is purported to have a protective and supportive role for adolescents. This editorial reflects upon challenges in parenting adolescents, and the need for nuanced re-examinations of the role of parenting in today’s globalized, hyper-connected, yet isolating, constantly changing environments.

Measuring parent-adolescent interactions in natural habitats. The potential, status, and challenges of ecological momentary assessment

Few people are as important for an adolescent's development as their parents. However, most research on parent-adolescent relationships describes long-term population-wide effects. Therefore, little is known about everyday interactions between adolescents and parents in individual families. Ecological momentary assessment (EMA) measures families several times a day as they go through daily life. This approach provides ecologically valid insights into which interactions took place and how they were experienced. State-of-the-art EMA studies suggest that within-family fluctuations in parenting may trigger changes in an adolescent's well-being and behaviors. In practice, moreover, EMA may strengthen family support and intervention research. This article reviews recent empirical work, highlights the (un)used theoretical and practical promise of EMA and identifies key-challenges to unlock this full potential.