Integrating "Super Skills for Exams" Programme in the School Curriculum to Support Adolescents Preparing for Their National Examinations in Turkey

Examination stress is the most common stressor reported by adolescents across the globe. Exam stress involves mental distress related to anticipated academic challenges or fear of failure in the examinations, test anxiety, or fear of being unable to meet certain expectations of themselves or others. The aim of this study was to determine the effectiveness of a transdiagnostic resilience program (Super Skills for Exams; SSE), when integrated in the school curriculum and delivered by the school counsellors, in reducing exam stress among adolescents who are preparing for their national examinations. SSE is based on the principles of Cognitive Behaviour Therapy (CBT), behavioural activation, and social skills training, and includes sessions in promoting healthy lifestyles. Participants were 7129 (3661 female and 3468 male) adolescents in grades 7 and 8, from all the 245 secondary schools from Ugur College in seven regions and 31 cities across Turkey. All the participants completed a set of questionnaires to measure self-efficacy for learning and test anxiety, academic stress, emotion regulation, and lifestyles. Results revealed significant reduction in academic stress (i.e., test anxiety, work pressure, self-expectation, and despondency) and maladaptive emotion regulation strategies, and significant increase in self-efficacy and adaptive regulation strategies following the intervention. Adolescents who participated in SSE reported an increase in the consumption of healthy food. This study provides preliminary empirical support for the integration of SSE within the school curriculum for helping adolescents cope with exam stress as they prepare for their national exams.

Childhood emotional dysregulation paths for suicide-related behaviour engagement in adolescence

This study aimed at identifying the heterogeneous trajectories of emotional dysregulation across childhood and to study the relationship between specific trajectories and adolescent suicide-related behaviour (SRB). Data from the Millennium Cohort Study (N = 13,853 children; 49.07% female, M = 3.13 years at baseline, SD = 0.2) were used to identify the emotional dysregulation trajectories from 3 to 8 years old, using growth mixture modelling. Moreover, 1992 participants (52.86% female) from the initial sample were used to study the relationship between childhood emotional dysregulation trajectory and engagement in both self-harm and suicide attempt at age 17, using logistic regression. Some other time-invariant and proximal (adolescent) risk factors were incorporated into this analysis. Six emotional dysregulation trajectories were identified. Self-harm at age 17 was significantly associated with the history of self-harm and other proximal factors, but not with emotional dysregulation trajectory membership. Childhood trajectories featured by earlier emotional dysregulation were associated with higher risk of lifetime suicide attempt, as well as other proximal factors (concurrent self-harm). This study found differential risk profiles involved in both SRB forms. A relationship between early emotional dysregulation and suicide attempt engagement in adolescence was identified. Early interventions should be developed to deal with SRB risk factors from childhood.

From ToyBox Study to eToyBox: Advancing Childhood Obesity Reduction in Malaysian Kindergartens

Prevention and treatment of childhood obesity is a global concern, and in Malaysia, it is considered a national public health priority. Determinants of childhood obesity are multifactorial and include factors that directly and indirectly influence energy balance-related behaviours, including energy intake and energy expenditure. Interventions to address childhood obesity that have multiple components at different levels have been shown to be the most influential. The ToyBox-study is a childhood obesity intervention aimed at preschool-aged children and their families that had been shown to be effective in several European countries and so was chosen for adaption for the Malaysian setting. Materials were translated and adjusted for the Malaysian context and audience and implemented in kindergartens in Peninsular Malaysia and Sarawak. However, during the COVID-19 pandemic and lockdown, teaching transitioned to being online. This brought an opportunity to reach a wider audience and consider the long-term sustainability of the intervention, and thus eToybox was born. eToybox aims to bring support for healthy energy balance behaviours directly to the teachers, into kindergartens and homes, to encourage families to be active and eat healthily, and prevent or reduce obesity. Through online innovation, the Toybox Study Malaysia programme has been expanded to enhance its potential to impact the promotion of healthy lifestyles among preschoolers and their families, highlighting the importance of a holistic approach to preventing and treating childhood obesity in Malaysia.

Comorbidity Between Internalising and Externalising Disorders Among Adolescents: Symptom Connectivity Features and Psychosocial Outcome

Internalising disorders are highly prevalent conditions in adolescence and tend to co-occur with externalising disorders. The present study used a symptom network approach to examine the interplay between symptoms of internalising disorders among adolescents with comorbid internalising and externalising disorders. Data comes from the National Comorbidity Survey-Adolescent Supplement, a nationally representative survey of adolescents aged 13 to 18 years. The most central symptoms across the disorders in the network were poor self-esteem and worry. The comorbidity between anxiety and depression increases the probability of having comorbid externalising disorders. Adolescents with both internalising and externalising disorders had the highest rate of health service utilisation. Comorbidity group, lifestyle factors, deficits in cognitive and academic competence and coping skills were significant covariates of the mental health outcomes. Understanding comorbidity profile of internalising and externalising disorders and central symptoms that bridge these disorders could have important clinical implications.

Inventory of Callous-Unemotional Traits (ICU) Factor Structure and Measurement Invariance in an Adolescent Multinational Sample

OBJECTIVE

The Inventory of Callous-Unemotional Traits (ICU) is a widely used, comprehensive measure of callous-unemotional (CU) traits. While the ICU total score is used frequently in research, the scale's factor structure remains highly debated. Inconsistencies in past factor structure research appear to be largely due to the use of small non-representative samples and failure to control for method variance (i.e., item wording direction).

METHOD

The current study used a multitrait-multimethod (MTMM) confirmatory factor analysis (CFA) approach that considers both trait and method variance to test the factor structure of a 22-item version of the self-report ICU in a multinational community sample of 4,683 adolescents (ages 11-17).

RESULTS

Results showed that a hierarchical four-factor model (i.e., one overarching CU factor, four latent trait factors) that controlled for method variance (i.e., by allowing residuals from positively worded items to covary) provided the best fit (χ2 = 2797.307, df = 160, RMSEA=.059, CFI=.922, TLI=.888, SRMR=.045).

CONCLUSIONS

After controlling for method variance, the best-fitting factor structure is consistent with how the ICU was developed and corresponds to the four symptoms of Limited Prosocial Emotions (LPE) specifier in the DSM-5 criteria for Conduct Disorder (CD). In addition, measurement invariance of this factor structure across age (i.e., younger versus older adolescents) and sex was supported. As a result, mean differences in ICU total score across age and sex can be interpreted as reflecting true variations in these traits. Further, we documented that boys generally scored higher than girls on the ICU, and this sex difference was larger in later adolescence.

Relationship between Social Anxiety Symptoms and Behavioral Impairment in Adolescents: The Moderating Role of Perfectionism and Learning Motivation

Numerous studies have found that adolescents with social anxiety disorder experience greater difficulty in school adjustment and show higher dropout rates. Perfectionism and learning motivation are known to be significant predictors of academic achievement; these factors may enhance or diminish behavioral impairment within the school setting. The purpose of the present study was to examine the relationship between social anxiety, learning motivation, perfectionism, and behavioral impairment within a community sample of adolescents. Five hundred ninety-four German middle school students aged 12-17 years (mean age = 14.60, SD=1.64; 59.4% female) were recruited through their schools to respond to a questionnaire package consisting of Spence Children’s Anxiety Scale, the Child and Adolescent Perfectionism Scale, impact supplement of the Strengths and Difficulties Questionnaire, and intrinsic values subscale of Motivational Strategies for Learning Questionnaire. Results of correlational and multiple regression analysis showed that social anxiety symptoms were a significant predictor of distress and behavioral impairment, especially in friendship and classroom learning domains. It was shown that intrinsic learning motivation promotes classroom learning in students with high levels of social anxiety, whereas perfectionism interferes with domains outside the classroom, such as friendships and leisure activities. Limitations and implications for future research were discussed.

Digital behaviour change interventions to promote physical activity in overweight and obese adolescents: a systematic review protocol

BACKGROUND

With the increasing prevalence of obesity in youth, behavioural interventions to alter its modifiable risk factors such as physical activity can support the management of this epidemic. Digital behaviour changes interventions (DBCI) such as mobile applications, websites and wearables have the potential to reach many adolescents to promote physical activity as its use may be more accessible, effective and engaging compared to traditional face-to-face approaches. However, there is insufficient evidence on their use at promoting physical activity amongst overweight and obese adolescents. This review aims to assess the effectiveness of DBCIs aiming to increase physical activity in overweight and obese adolescents (aged 10-19 years) and the behaviour change techniques used in these interventions.

METHODS

Electronic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane and Scopus) will be searched for English language studies from January 2000 to December 2022 using appropriate search terms relating to digital interventions, physical activity, adolescents and obesity. Experimental studies (either randomised or non-randomised controlled trials) assessing effects of DBCIs on physical activity behaviour, objectively or subjectively measured, in overweight and obese (body mass index [BMI] ≥ 85th percentile for age) adolescents will be eligible for inclusion. Intervention characteristics will be coded using the Template for Intervention Description and Replication (TIDieR) checklist and the BCT taxonomy v1. Risk of bias and the overall quality of the included studies will be assessed using Cochrane's Collaboration's tool and GRADE approach respectively. If the data allows, meta-analyses using random effect models will be conducted to assess the effects of DBCIs on physical activity.

DISCUSSION

The proposed systematic review will summarise the effectiveness of digital behaviour change interventions aiming to increase physical activity in overweight and obese adolescents, as well as adding new information on the behaviour change techniques used in these interventions. The findings of this review will facilitate stakeholders with a current, rigorous and reliable research base to support the development and implementation of effective health promotion interventions for this population.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42021270008.

Stigmatization of people with alcohol and drug addiction among Turkish undergraduate students

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Females were more fearful of people with alcohol, marijuana and heroin addiction than males.

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Younger compared to older participants perceived those with substance addiction as more dangerous.

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Younger participants were more fearful of people with substance addiction than older participants.

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Younger than older participants had higher social distance towards people who are addicted to alcohol and marijuana.

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Perceived dangerousness and fearfulness partially mediated the relationship between stigma and social distance.

Introduction

Stigmatization of people with substance use problems have been reported to be high among young adults in Western countries. It is not clear if this finding could be replicated among emerging adults in non-Western countries. Thus, the aim of this study was to firstly explore stigmatizing attitudes of undergraduate students in Turkey towards people with alcohol, marijuana and heroin addiction, and then test a mediation model to explain stigmatizing attitudes among college students.

Method

A total of 513 undergraduate students participated in the study. They completed a set of questionnaires to measure perceived stigma towards substance use, perceived danger and feeling fearful towards people with substance addiction (i.e., alcohol, heroin, marijuana), and a willingness to engage in relationships with people who are addicted to these three substances.

Results

Females, compared to males, reported being more fearful of people who are addicted to alcohol, marijuana and heroin. Younger compared to older participants perceived people who are addicted to these substances as more dangerous. Younger participants also had higher social distance towards people who are addicted to alcohol and marijuana than older participants. Perceived dangerousness and fearfulness partially mediated the relationship between perceived stigma and social distance in alcohol, marijuana and heroin.

Conclusion

Research findings may help determine potential correlates of stigmatizing attitudes as well as developing models to explain stigmatizing attitudes among Turkish college students.

Is the relationship between problematic mobile phone use and mental health problems mediated by fear of missing out and escapism?

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Higher level of problematic mobile phone use was associated with higher level of mental health problems, Fear of Missing Out (FoMO) and escapism.

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Higher level of mental health problems was associated with higher level of FoMO.

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Higher level of FoMO and worry was associated with higher level of escapism.

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The association between problematic mobile phone use and mental health problems was not mediated by FoMO and escapism.

Introduction

Individuals with problematic mobile phone use often report mental health problems, however, little is known about factors which mediate this association. Therefore, the aim of this study was to examine the mediating role of fear of missing out (FoMO) and escapism in an attempt to explain the relationship between problematic mobile phone use and mental health problems.

Method

A total of 235 undergraduate students in Turkey participated in this study. These participants completed a set of questionnaires to measure fear of missing out, problematic mobile phone use, escapism, depression, anxiety, stress, and worry severity.

Results

Participants with a high level of problematic mobile phone use also had a high level of mental health problems, FoMO, and escapism. The association between problematic mobile phone use and mental health problems was not mediated by FoMO and escapism.

Conclusion

Personal characteristics such as emotional regulation and self-regulation need to be examined in future studies in order to determine their potential mediating role in explaining the association between problematic mobile phone use and mental health problems.

Prevalence of addictive behaviours among adolescents from 73 low-and middle-income countries

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The prevalence of regular alcohol use was the highest among adolescents in Zambia but the lowest in Senegal.

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The prevalence of problematic alcohol use was higher in Argentina and Colombia than in any other low- and middle-income countries.

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The prevalence of regular and problematic alcohol use was the lowest in countries with Muslim and Buddhist religions.

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Samoa had the highest prevalence of smoking as well as in marijuana and amphetamine consumption.

Introduction

Adolescence is a critical developmental stage for the initiation of substance use worldwide. However, the prevalence of various types of substances consumed by adolescents living in low- and middle- income countries (LMICs) across different continents is not fully understood.

The aims of the present study were to estimate the prevalence of regular and problematic substance use among adolescents in 73 LMICs across different continents and to explore the role of country-specific factors on this prevalence.

Method

Data of 314,187 adolescents (52.79% girls; median age = 15 years old) who participated in the Global School-based Student Health Survey (GSHS) were analysed. After estimating the weighted prevalence for each country, multilevel models were used to examine the influence of country-specific factors on the prevalence of substance use across 73 LMICs.

Results

The results indicated that problematic alcohol use was more prevalent in LMICs with higher income levels. The prevalence of regular alcohol use was the highest in Zambia. Regular and problematic alcohol use was the least prevalent in Senegal and Myanmar. The findings also revealed that smoking and the consumption of marijuana and amphetamine were the most common among adolescents in Samoa, whereas the prevalences for these substances were the lowest in Laos.

Conclusion

Economic wealth, religion and geographical factors seem to have a role in determining the prevalence of substance use among adolescents in LMICs.

Effects as a function of implementation fidelity of a transdiagnostic prevention program in young school-aged children

Super Skills for Life (SSL) is a transdiagnostic prevention program for school-aged children with internalizing problems. The current study aimed to examine the short- and long-term (12-month follow-up) effectiveness of SSL, depending on implementation fidelity. Participants were 123 Spanish-speaking children aged 6-8 years with internalizing symptoms and their parents. High (n = 41) and low fidelity (n = 26) groups were established and compared with a control group (CG) (n = 56). Compared to CG, the high-fidelity group (HFG) achieved better outcomes than the low-fidelity group (LFG) at short and long term, including symptoms of anxiety, depression, and internalizing problems, and also externalizing problems at long-term. The LFG improved key symptoms at short term (depression) and long term (anxiety and depression). Findings suggest that SSL is beneficial even if not delivered at maximum fidelity, although considering the influence of implementation fidelity is critical because the high-fidelity implementation yielded the greatest effects when compared to the CG. This research provides valuable data, analyzing for the first time the influence of fidelity on SSL outcomes in young school-aged children exhibiting internalizing symptoms, while there is still a lack of studies of these characteristics concerning transdiagnostic prevention programs targeting childhood anxiety and depression.

Factors related to substance use among adolescents from six low-and middle-income countries

Substance use is a common public health problem among adolescents in low- and middle-income countries (LMICs), however, factors that are associated with this condition are not clearly understood. The aim of the present study was to examine personal and interpersonal factors that contribute to risk for substance use among adolescents in six ASEAN (Association of Southeast Asian Nations) LMICs (i.e., Indonesia, Laos, Malaysia, Myanmar, Philippines and Thailand). Data of 57,825 adolescents (52.64% girls; median age = 14 years old) who participated in the Global School-based Student Health Survey (GSHS) were analysed. After the weighted prevalence was estimated for each country, multilevel models were employed to examine the influence of the risk factors on the prevalence of substance use across the countries. The results indicated a high prevalence of substance use among adolescents in all these six ASEAN LMICs. Alcohol use, smoking and drug use were more prevalent among adolescents in Thailand, Laos and Philippines. Adolescents who were bullied and who had no close friends had a high prevalence of alcohol and drug use. Problematic drinking and smoking were more prevalent among older adolescents, and smoking and drug use were more prevalent among boys. Furthermore, frequent worry, loneliness and regular physical activity were found to predict adolescents' heavy and binge drinking. This study contributed to knowledge on risk factors for specific substance use among adolescents and drew attention for the urgent need to strengthen the intervention, law policies and professional support for reducing substance use in ASEAN LMICs.

Acceptability and feasibility of using digital technology to train community practitioners to deliver a family-based intervention for adolescents with drug use disorders during the COVID-19 pandemic

INTRODUCTION

By adhering to government preventative messages to stay-at-home and social distancing during the COVID-19 pandemic, training practitioners in person in implementing a family-based intervention (i.e., Treatnet Family) is not possible. The present study examined the feasibility and acceptability of using digital technology to remotely deliver Treatnet Family training to practitioners in community counselling services in Indonesia.

METHOD

Fifteen practitioners, from the association of addiction counsellors in Indonesia, participated in the Treatnet Family workshop remotely. The training was delivered by four national Treatnet Family trainers remotely via a digital platform for five days with additional take-home assignments.

RESULTS

All practitioners reported that Treatnet Family training have enhanced their skills in working with adolescents and their family. Most practitioners reported having confidence in conducting Treatnet Family and in applying core skills of family-based intervention. Participating in the workshop enabled practitioners to learn the core skills of the Treatnet Family at their own pace. However, some practitioners also stated few disadvantages in remote training, including having limited time for the discussion and feeling overwhelmed with the assignments. Some find it hard to attend such training from their home due to distractions.

CONCLUSION

Digital technology is acceptable and feasible method for training community practitioners to deliver Treatnet Family to adolescents with SUDs and their families in Indonesia. These findings can inform the way to use digital technology to deliver core family-based skills to community practitioners in other low-resource settings.

Internet use during COVID-19 lockdown among young people in low- and middle-income countries: Role of psychological wellbeing

Problematic internet use in adolescents has been shown to significantly increase over the past few years, with COVID-19 pandemic lockdowns reinforcing this phenomena globally. We sought to explore whether problematic internet use in specific countries was related to emotional well-being and importantly whether this is predicted by psychological distress. There is a growing number of studies showing that problematic internet use is increasingly prevalent in countries with emerging economies, however we have yet to find out to what extent other factors are influencing this behaviour in adolescents and young people. This study invited young people from countries such India, Mexico, Philippines and Turkey to complete a set of self-reports on their daily internet habits, social media use, alongside questions on psychological distress, self-esteem, loneliness and escapism. A total of 1182 young people aged between 16 and 25 years old completed these questionnaires online. The results showed that there were significant difference in problematic internet use scores among adolescents in the Philippines and Turkey. More specifically, social media use was significantly higher amongst young people from the Philippines whereas gaming addiction was significantly high in the Turkish sample. These findings also revealed that psychological distress, loneliness, and low self-esteem consistently predicted problematic internet use. Taken together these results emphasise that there are several factors underlying growing figures of problematic internet use in young people, these factors include emotional distress, need for escapism, loneliness, and social media use, however, going forward more nuanced cultural differences should also be considered.

Adolescent psychopathological profiles and the outcome of the COVID-19 pandemic: Longitudinal findings from the UK Millennium Cohort Study

BACKGROUND

Public health measures to contain the spread of COVID-19 have resulted in adverse effects, including high level of psychological distress, anxiety, and depression.

AIMS

This study explored adolescent psychopathological profiles at age 17, and their role in predicting the impact of the COVID-19 pandemic at age 19.

METHODS

The analyses used a sample of 904 participants (mean age = 19.17 years) from the Millennium Cohort Study (MCS) sweep 7 who completed the mental health questions from January 2018 to March 2019 (mean age = 17.18 years) and the COVID-19 Survey in May 2020. Adolescent psychopathological profiles were identified by means of latent class analysis.

RESULTS

Four psychopathological profiles were identified: "low-symptom class" (60.17% of participants), "high-symptom class" (23.01% of participants), "substance/behavioural addictions class" (12.03% of participants), and "emotion-dysregulation class" (4.79% of participants). Adolescents in the high-symptom and emotional-dysregulation classes had the worst outcome during the lockdown. Specifically, they experienced more stress, conflict and loneliness, and lower levels of perceived social support than adolescents in the other psychopathological classes. Adolescents in the emotional-dysregulation class also consumed more alcohol and had worse financial situation during the lockdown compared to pre- lockdown period.

CONCLUSION

Adolescent psychopathological profiles predicted mental health impacts of the COVID-19 outbreak.

An open trial investigation of Treatnet Family among adolescents with substance use problems

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Treatnet Family (TF) had a positive significant impact in reducing alcohol use.

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After participating in the TF, the adolescents were engaged with significantly fewer friends who consumed substances and participated in antisocial behaviours.

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The two most reported life events (i.e., “got in a lot of arguments or fights” and “had problems with drugs or alcohol”) before the intervention were significantly decreased at the follow-up assessment.

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Based on parent’s/family member’s reports, there was a significant decrease in mental health problems across time.

Introduction

Studies that used evidence-based family therapies have demonstrated significant effects in reducing adolescent drug use and delinquent behaviours, and in reducing comorbid mental health problems. However, almost all these studies were conducted in high-income countries. The overall aim of the present study was to explore the effect of United Nations Office on Drugs and Crime’s (UNODC) Treatnet Family (TF) in reducing substance consumption, drug-related activities, reducing mental health problems, and in improving family interaction among adolescents with substance-use problems.

Method

Nineteen adolescents who had been referred to a community counselling clinic because of substance-use problems and their parents/family members participated in TF. They completed a set of questionnaires to measure substance use, family functioning, mental health problems, and life events at pre-, post-intervention as well as at a one month-follow-up assessment.

Results

TF had a positive significant impact in reducing alcohol use among adolescents with substance-use problems. The number of adolescents who smoked cigarettes and marijuana, and used amphetamines reduced across time. After participating in TF, the adolescents were involved with significantly fewer friends who consumed substances and participated in antisocial behaviours. Furthermore, parent/family member reported a significant decrease in mental health problems, and positive changes in adolescent’s behaviours.

Conclusion

The TF had a positive impact in reducing alcohol consumption and problems related to substance consumption among adolescents with substance-use problems when delivered by practitioners in routine community settings.

Research Review: Recommendations for reporting on treatment trials for child and adolescent anxiety disorders - an international consensus statement

BACKGROUND

Anxiety disorders in children and young people are common and bring significant personal and societal costs. Over the last two decades, there has been a substantial increase in research evaluating psychological and pharmacological treatments for anxiety disorders in children and young people and exciting and novel research has continued as the field strives to improve efficacy and effectiveness, and accessibility of interventions. This increase in research brings potential to draw together data across studies to compare treatment approaches and advance understanding of what works, how, and for whom. There are challenges to these efforts due largely to variation in studies' outcome measures and variation in the way study characteristics are reported, making it difficult to compare and/or combine studies, and this is likely to lead to faulty conclusions. Studies particularly vary in their reliance on child, parent, and/or assessor-based ratings across a range of outcomes, including remission of anxiety diagnosis, symptom reduction, and other domains of functioning (e.g., family relationships, peer relationships).

METHODS

To address these challenges, we convened a series of international activities that brought together the views of key stakeholders (i.e., researchers, mental health professionals, young people, parents/caregivers) to develop recommendations for outcome measurement to be used in treatment trials for anxiety disorders in children and young people.

RESULTS AND CONCLUSIONS

This article reports the results of these activities and offers recommendations for selection and reporting of outcome measures to (a) guide future research and (b) improve communication of what has been measured and reported. We offer these recommendations to promote international consistency in trial reporting and to enable the field to take full advantage of the great opportunities that come from data sharing going forward.

The Mediating Effects of Self-Esteem on Anxiety and Emotion Regulation

Individuals with anxiety disorders maladaptively appraise interpersonal threat cues leading to inaccurate interpretations of the self and others. However, little is known about the factors that mediate this association, therefore, the main aim of this study was to examine the relationship between state and trait anxiety, self-esteem, and emotion regulation strategies: reappraisal and suppression. Young adults aged between 18-26 years participated in the study. They completed a set of self-reports measuring emotion regulation, self-esteem, state-trait anxiety, and positive and negative attributes. Participants also completed an experimental task, using the dot-probe paradigm, which measures threat bias and response inhibition. The findings showed that trait and state anxiety predicted suppression, reappraisal, and internalising problems, and is linked to response inhibition. Importantly, low self-esteem, significantly mediated the relationship between increased anxiety and suppression. Taken together, these results show specific associations between emotion regulation and anxiety, highlighting the significant impact of self-esteem in young adults.

Parent's psychopathological profiles and adolescent offspring's substance use disorders

BACKGROUND

Substance use disorders (SUD) represent one of the most important public health problems which has an onset in adolescence. Although substantial data exist on adolescent substance use, studies examining the role of parental psychopathological profiles on adolescent offspring SUD are lacking. Thus, this study aimed to identify parental psychopathological profiles, and to examine the extent to which these profiles are associated with SUD in their offspring.

METHOD

Our analytic sample comprised 5887 adolescents (48.60% boys; M = 15.07 years, SD = 1.46) from the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), whose biological parents responded to the Parent Self-Administered Questionnaire. Parental psychopathological profiles were identified by means of latent class analysis.

RESULTS

Different psychopathological profiles were identified in fathers and mothers. Among fathers, two psychopathological profiles were found: "normative class" (low psychopathological symptoms and drug use) and "high psychopathology class" (high psychopathological symptoms and drug use). Among mothers, three psychopathological profiles were found: "normative class" (low psychopathological symptoms and drug use), "high psychopathology class" (high psychopathological symptoms and drug use), and "suicide class" (low psychopathological symptoms and drug use, but high on suicidal ideation or suicidal attempt). Father's high psychopathology profile was significantly associated with adolescent's illicit drug abuse. Mother's high psychopathology profile was significantly associated with adolescent's nicotine dependence, alcohol or illicit drug abuse.

CONCLUSIONS

Family-based interventions should include skills training in reducing parental SUD and other mental health problems.

Effectiveness of the Super Skills for Life programme in enhancing the emotional wellbeing of children and adolescents in residential care institutions in a low- and middle-income country: A randomised waitlist-controlled trial

BACKGROUND

The present study examined the effectiveness of a transdiagnostic prevention programme, Super Skills for Life (SSL), among children and adolescents with emotional problems in residential care institutions (RCIs) in the low- and middle-income country of Mauritius using a randomised waitlist-controlled trial (RCT). SSL is based on the principles of cognitive behavioural therapy, behavioural activation, social skills training, and uses video-feedback and cognitive preparation as part of the treatment.

METHODS

The RCT involved 100 children and adolescents aged 9 to 14 years, from six RCIs, randomly allocated to either an SSL intervention group (IG) or a waitlist-control (WLC) group. A set of questionnaires measuring internalising and externalising problems, emotion regulation and self-esteem, and experimental tasks measuring attentional bias and inhibitory control, were completed at baseline, post-intervention and 3-month follow-up. Participants also completed a 2-min video speech task during the first and final sessions of the SSL intervention.

RESULTS

Children and adolescents in the IG showed significant improvements in internalising symptoms (e.g. anxiety and depression), externalising symptoms (e.g. conduct problems and hyperactivity), and inhibitory control, and an increase in adaptive (except putting into perspective strategy) and decrease in maladaptive emotion regulation strategies, at both post-intervention and follow-up. These findings were not replicated among children in the WLC.

LIMITATIONS

The small sample size and lack of an active control group were the major limitations of this study.

CONCLUSIONS

This study provides evidence for the effectiveness of a transdiagnostic prevention programme for emotional problems in RCIs in a low- and middle-income country.

Impact of a transdiagnostic prevention protocol for targeting adolescent anxiety and depression

The present study examined the benefit of a transdiagnostic prevention program, Super Skills for Life (SSL), among adolescents with internalizing and/or externalizing problems in two types of school settings (mainstream school and pupil referral unit) using a randomized waitlist-controlled trial (RCT). The main aims were to examine the effects of the SSL-A in reducing internalizing and externalizing problems in adolescents, and to identify the moderating role of gender, age, and school type on the intervention outcome. The RCT involved 112 adolescents aged 11 to 14 years old, randomly allocated to either an SSL intervention group or a waitlist-control group (WLC). Adolescents in the intervention group participated immediately in the SSL-A, whereas adolescents in the WLC group received the intervention after the intervention group completed the 6 months follow-up assessment. Results showed that internalizing and externalizing problems were significantly reduced from pre-test to follow-up assessments. Gender, age and school setting moderated the intervention outcome. Specifically, males, younger adolescents and adolescents from mainstream schools showed a significant reduction over time on both internalizing and externalizing problems. This study provides evidence for the benefits of a transdiagnostic prevention program for internalizing and externalizing problems in two types of school settings.

The impact of COVID-19 lockdown on internet use and escapism in adolescents

The COVID-19 pandemic has had a significant impact on everyday functioning, considerable measures being taken to reduce the spread of the virus. Schools and social avenues have been placed on prolonged lockdowns, with people continuing to maintain physical distance. Adolescents and young people have had to endure significant stress alongside dealing with developmental characteristics. Amidst all of this, studies report an increase in gaming addiction and internet use with detrimental impact on psychosocial well-being. The aim of the present study was to examine the impact of lockdown on internet use in adolescents, comparing their habits from before the pandemic. Furthermore, this research aimed to investigate the relationship between gaming addiction, internet use and COVID-19 worries. Adolescents from several countries (e.g., India, Malaysia, Mexico and the UK) completed online questionnaires, shared via social media and youth networks. These measures included questions on internet, social media, gaming, depression, loneliness, escapism and COVID-19. Results show that adolescents generally have increased their use of social media sites and streaming services. Further, those who scored highly on gaming addiction, compulsive internet use and social media use also reported high scores of depression, loneliness, escapism, poor sleep quality and anxiety related to the pandemic. Our findings indicate that, regardless of country of residence, the COVID-19 outbreak has had a significant effect on adolescent internet use and psychosocial well-being. The need to address pandemic related distress to reduce the effect of maladaptive coping strategies is highlighted

Psychological effects of the COVID-19 lockdown on children and families in the UK

The implementation of measures (e.g. school closure and social distancing) to contain the spread of COVID-19 by government in numerous countries has affected millions of children and their families worldwide. However, the consequences of such measures on children’s wellbeing are not fully understood. The aim of the present study was to examine the psychological impact of the COVID-19 lockdown on primary school children and their families living in the UK. A total of 927 caregivers with children aged between 5 and 11 years completed an online survey which included a set of questionnaires to measure their own behaviour and emotional state as well as that of their children before and during the lockdown. Caregivers reported changes in their children’s emotional state and behaviours during the lockdown. The most frequently reported child symptom was boredom (73.8%), followed by loneliness (64.5%) and frustration (61.4%). Irritability, restlessness, anger, anxiety, sadness, worry and being likely to argue with the rest of the family was reported by more than 30% of the caregivers. During the lockdown, children spent significantly more time using screens, and less time doing physical activity and sleeping. Moreover, family coexistence during the lockdown was described as moderately difficult. More than half of the caregivers reported being moderately or seriously distressed during the lockdown and caregiver level of psychological distress was significantly related to child symptoms. The findings emphasised the importance of developing prevention programmes to mitigate the impact of COVID-19 pandemic on children’s and their family’s psychological wellbeing

Patterns, predictors, and outcome of the trajectories of depressive symptoms from adolescence to adulthood

BACKGROUND

The long-term trajectory of depressive symptoms has a heterogeneous pattern. Identifying factors associated with different trajectories and outcomes may have important theoretical and clinical implications. This study explored patterns of depressive symptom trajectory from adolescence to adulthood, and their relationship with subsequent psychiatric disorders.

METHOD

A sample of 816 participants (58.8% girls; M = 16.58 years old at baseline, SD = 1.21) from a large community sample were interviewed four times during adolescence and adulthood. Depressive symptoms were also assessed. Symptom trajectory identification was based on latent class mixed modeling. Logistic regression was used for predicting emotional and drug use disorder over age 30.

RESULTS

Three trajectories of depressive symptoms were identified: "decreasing symptom" (decreasing trajectory of symptoms; 15.1% of participants), "increasing symptom" (initially decreasing pattern of symptoms and then increasing; 6.1% of participants), and "normative symptom" (consistently low symptom levels; 78.8% of participants). Predictors of the increasing symptom trajectory were high level of loneliness and state anxiety, presence of an emotional disorder, and low involvement in physical exercise at baseline. This trajectory membership predicted the development of anxiety disorders over age 30. Predictors of the decreasing symptom class were being female and high level of worry at baseline.

CONCLUSIONS

Long-term trajectories of depressive symptoms are heterogeneous, with each trajectory having different predictors and are associated with different outcomes during adulthood.

Effects of a transdiagnostic cognitive behaviour therapy-based programme on the natural course of anxiety symptoms in adolescence

BACKGROUND

Anxiety disorders frequently have an onset during adolescence, which when left untreated could lead to a chronic course and outcome. This study aimed to examine the way in which a cognitive behaviour therapy-based programme (Super Skills for Life - adolescent version; SSL-A) could change the course of anxiety symptoms through adolescent's behavioural performance and cardiac function.

METHOD

Sixty-one adolescents at risk of developing an anxiety disorder (45.30% boys; M = 13.76 years, SD = 0.32) were randomly assigned to either an intervention (IG), placebo (PG), or a waitlist group (WG). Adolescents in the IG participated in SSL-A over an 8-week period. Adolescents in the PG participated in an 8-session school-work programme. Adolescents in the WG did not receive any intervention. Anxiety symptoms were assessed every six months, twice before the intervention, as well as at the post-intervention and six months after the intervention. Participants in the IG additionally underwent a stressful task to assess behavioural performance and cardiac adjustment.

RESULTS

Adolescents in the IG significantly reported lower levels of social phobia and generalised anxiety symptoms at the follow-up assessment compared to the adolescents in the PG and the WG. They also showed a significant improvement in vocal quality and lower discomfort during a stressful task at post-intervention, and showed attenuated cardiac recovery indexes, in terms of sample entropy.

LIMITATIONS

The study has a small sample size.

CONCLUSION

SSL-A changed the natural course of anxiety symptoms, as shown by a significant reduction in social phobia and generalised anxiety symptoms, and a significant improvement in behaviour and physiological (cardiac) function during a stressful situation.

Poly-Victimization in Polish Adolescents: Risk Factors and the Moderating Role of Coping

This study aimed to investigate the prevalence of poly-victimization in Polish adolescents and assess factors associated with poly-victimization risk across different ecological levels. This study further examined whether coping styles could moderate the impact of poly-victimization on emotional well-being. Participants were 454 adolescents, aged between 13 and 19 years, from an urban region of Poland. Adolescents completed self-report measures assessing community, school, and family risks, along with a peer nomination task measuring social preference. Teachers also completed a measure assessing adolescent problem behaviors. Findings revealed that the majority of the sample (70%) experienced more than one type of victimization in the past year, and 35.7% were classified as poly-victims (≥ 6 victimizations). As hypothesized, community disorganization, low commitment to school, poor family management, family conflict, peer social preference, and teacher-rated withdrawn and disruptive behavioral problems were predictive of poly-victimization. In addition, the relationship between poly-victimization and emotional well-being was moderated by problem-solving coping, in that greater use of problem-solving strategies lessened the negative impact of poly-victimization on positive affect and life satisfaction. Other investigated coping strategies (social support-seeking, internalizing, externalizing, and distraction) failed to demonstrate any moderation effect. Findings highlight the high rate of victimization experienced by adolescents in Poland and have implications for the identification of those at risk of poly-victimization, suggesting that there is a need to consider factors related to the adolescent themselves, their relationships with family and peers, and school and community factors. Results also indicate that there may be value in training victims in the use of problem-solving coping styles as a source of resilience.

One-Year follow-up effects of a cognitive behavior therapy-based transdiagnostic program for emotional problems in young children: A school-based cluster-randomized controlled trial

BACKGROUND

The present study examined the long-term efficacy of a transdiagnostic prevention program, Super Skills for Life (SSL), among young children with emotional problems. SSL is based on the principles of cognitive behavioral therapy, behavioral activation, and social skills training.

METHODS

One-hundred and twenty-three Spanish-speaking children, aged 6 to 8 years, and their parents participated in the study. They were recruited from ten schools. Schools were randomly allocated to either the intervention (IG) or waiting-list control (WLC) groups. The children's parent completed a set of questionnaires to measure their child's anxiety and depressive symptoms, general difficulties and positive attributes, and psychosocial impairment. Parent's assessment at baseline and at a 12-month follow-up was assessed using an intent-to-treat approach.

RESULTS

The IG, compared to WLC group, showed significant baseline-to-follow-up reductions in anxiety and depressive symptoms, as well as in behavioral difficulties and psychosocial impairment in various life domains.

LIMITATIONS

The small sample size and the reliance on parental reports were the major limitations of this study.

CONCLUSIONS

This study provides initial evidence of the long-term effects of SSL, suggesting that it is a promising indicated preventive intervention for young children with emotional problems.

Validity and Reliability of a Food Frequency Questionnaire (FFQ) to Assess Dietary Intake of Preschool Children

As there are few food frequency questionnaires (FFQ) to assess the dietary intake of preschool children, this study examined the validity and reliability of an FFQ for this purpose. A total of 210 preschoolers aged 4 to 6 years participated in the validation study, while a subsample of 66 participants joined the reliability study. The FFQ is modified from the ToyBox-study and South East Asian Nutrition Surveys (SEANUTS), and comprised 108 food items from 13 food groups. A three-day estimated dietary record (3DR) was used as reference and reliability was assessed through a second administration of the FFQ (FFQ2), four weeks after the first administration (FFQ1). For the validation study, Spearman’s correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ and 3DR. Cross-classification of quartile analysis showed moderate agreement between the two methods. As for reliability, Spearman’s correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ1 and FFQ2. Cronbach’s alpha values (0.708 to 0.824) and intraclass correlation coefficients (0.710 to 0.826) showed good agreement between repeated FFQs. The results suggest that the FFQ has acceptable validity and good reliability. Hence, the FFQ can be used to assess preschool children’s food intake.

Symptom network connectivity in adolescents with comorbid major depressive disorder and social phobia

PURPOSE

Major depressive disorder (MDD) and social phobia (SP) are both common and highly co-occurring psychiatric disorders. This study used symptom network analysis approach to examine comorbidity structure and the complex symptom dynamics which may play a role in the co-occurrence of MDD and SP.

METHOD

Data comes from the National Comorbidity Survey - Adolescent Supplement, a nationally representative survey of adolescents ages 13 to 18 years. This study examined data of adolescents with a lifetime diagnosis of MDD (n = 597), SP (n = 708), and adolescents with comorbid MDD and SP (n = 189). Networks were estimated by means of 26 symptoms from both disorders.

RESULTS

All MDD and SP symptoms were involved in the network of both pure disorders (MDD; SP) and comorbid condition (MDD + SP). Network structure was different between the pure disorders (p = 0.014), but not when comparing each of these disorders that have comorbid condition. Depressive symptoms of poor self-esteem and suicidal symptoms were central (i.e., showed a higher influence) in the symptom network for the pure disorders and for the comorbid condition. Other key symptoms in the comorbid condition network were two depressive symptoms: feelings of worthlessness and anhedonia. SP and MDD networks showed two common key SP symptoms: feeling uncomfortable when meeting new people and feeling uncomfortable talking to people do not know well.

CONCLUSION

The study of symptom dynamics will provide useful targets for preventing the development of comorbid disorders as well as new lines of intervention to deal with key symptoms of psychiatric disorders.

Comorbidity profile of mental disorders among adolescents: A latent class analysis

The aim of this study was to identify the number of comorbidity profiles among adolescents. Sociodemographic factors associated with the comorbidity profiles were also examined. Latent class analysis was conducted using data from the National Comorbidity Survey Adolescent Supplement (NCS-A), a representative sample of adolescents (N = 10,123) in the United States. Latent classes were derived from 26 lifetime mental disorders which were assessed using the World Health Organization Composite International Diagnostic Instrument (CIDI). A three-class solution provided the best fit for the data, with classes labelled as comorbid emotional disorders (Class I), comorbid behavioural disorders (Class II), and normative (Class III). Class I (15.62% of the participants) included adolescents with a high probability of having anxiety, depressive, and intermittent explosive disorder. Class II (6.97%) was characterised by adolescents with a high probability of having substance use, behavioural disorders, and major depression. Class III (77.41%) was characterised by adolescents with a low probability of having any mental disorders. Characterising comorbid profile of mental disorders using person-based approach yields a higher-order classification that could have important clinical implications.

Effectiveness of the program Super Skills For Life in reducing symptoms of anxiety and depression in young Spanish children

BACKGROUND

Super Skills for Life (SSL) is a transdiagnostic prevention program designed for children with anxiety and depressive symptoms based on cognitive-behavioral therapy. This study is a trial of the efficacy of the SSL program to reduce anxiety and depression symptoms in a representative sample of Spanish children aged 6 to 8.

METHOD

This cluster randomized controlled trial involved 123 Spanish-speaking children recruited from 10 schools. Schools were the unit of randomization, and were randomly assigned to one of two experimental conditions: intervention group (SSL) and waiting list control (WLC) group. Assessments were conducted before and after the 8-week intervention.

RESULTS

Generalized estimating equations showed that, compared with WLC, the intervention significantly reduced emotional symptoms of anxiety and depression. Significant improvements were also found in specific symptoms of anxiety disorders, and in the interference of anxiety in the child´s life.

CONCLUSIONS

The findings of this study provide initial support for the immediate effects of SSL, suggesting that it is a valuable resource for the early reduction of anxiety and depressive symptoms in young Spanish-speaking children.

The impact of pre- and perinatal factors on psychopathology in adulthood

BACKGROUND

There is considerable evidence that pre- and post-natal factors are associated with a wide range of psychopathology in offspring during childhood and adolescence.

OBJECTIVE

The main aims of the present study were to examine the associations between pre- and perinatal factors and psychopathology in offspring during adulthood, and to explore whether family factors (i.e., family cohesion, mother's social support, and father's social support) mediate these relationships.

METHOD

Information on pre- and perinatal events was collected from biological mothers of the participants (N = 315) when they were between 14 and 18 years who were then followed up until they reached age 30.

RESULTS

Maternal obstetric history and illness during first year were significant predictors of offspring anxiety disorder. Maternal emotional health predicted offspring affective disorder. Difficult delivery and breast feeding predicted disruptive disorder. The relationship between maternal obstetric history/emotional health and anxiety/affective disorder was no longer significant after controlling for family cohesion.

LIMITATIONS

The information was based on maternal recall when their offspring were between 14 and 18 years which may be subjected to recall bias.

CONCLUSION

The association between pre- and postnatal factors and psychopathology of offspring during adulthood is mediated by familial factors.

Factor Structure of the Urdu Version of the Spence Children's Anxiety Scale in Pakistan

Spence Children's Anxiety Scale (SCAS) is one of the most commonly used self-report questionnaires to measure symptoms of anxiety disorders in adolescents. Despite its common use, studies that examine the psychometric properties of SCAS in Pakistan is lacking. Therefore, the purpose of this study was to examine the psychometric properties of the Urdu translated version of the SCAS among adolescents in Pakistan. A total of 1277 students (708 boys and 569 girls), aged 13 to17 years, who had been recruited from 13 schools in Rawalpindi, Pakistan participated in the study. The mean overall anxiety score was significantly higher in girls than males on all the SCAS subscales except for obsessive compulsive disorder. The internal consistency of the Urdu SCAS was good. Confirmatory factor analyses supported six separate factor structures. Results of the study are discussed with reference to the sociocultural milieu of Pakistan and culture sensitive conceptualization of anxiety and its subtypes.

Propiedades psicométricas del Centro de Estudios Epidemiológicos, Escala de depresión para adolescentes en Bulgaria

En el presente estudio se evaluaron las propiedades psicométricas de la versión búlgara de la “Centre for Epidemiological Studies Depression Scale” (CES-DC), una escala auto-informada de 20 ítems diseñada para medir síntomas depresivos en niños y adolescentes. Un total de 700 adolescentes (323 niñas y 377 niños), de 13 a 17 años, participaron en el estudio. Además de la escala CES-DC, los adolescentes también contestaron el “Strength and Difficulties Questionnaire” (SDQ) y el “Spence Child Anxiety Scale” (SCAS). Los resultados del análisis factorial confirmatorio mostraron índices de ajuste adecuados, demostrando la validez de las cuatro dimensiones de la escala original. La CES-DC correlacionó de manera significativa con las puntuaciones totales de la SDQ y sus subescalas, mostrando que niveles elevados de síntomas depresivos se asocian con niveles altos de problemas emocionales y conductuales. En general, los resultados evidencian la validez factorial y fiabilidad de la versión búlgara de la escala CES-DC en muestras adolescentes de Bulgaria.

Callous-Unemotional Traits in Children and Adolescents

Abstract. The Inventory of Callous and Unemotional Traits (ICU) was developed to measure callous-unemotional (CU) psychopathic traits in children and adolescents. Studies that have examined the factor structure of ICU showed considerable controversy. The aim of this study was to examine the factor structure and psychometric proprieties of the Portuguese translation of the ICU. A total of 1,011 children and adolescents (495 boys and 516 girls), mean age of 13.36 years, participated in this study. Exploratory factor analysis produced two factors: uncaring and callousness; Cronbach’s α for each of the factor was .83 and .79 for the total score. Significant main gender and interaction between gender and age effects were found; girls reported lower CU traits than boys; children reported higher CU traits compared to preadolescents and adolescents, particularly in boys. CU also correlated with emotional symptoms, conduct problems, and psychosocial impairment. Furthermore, CU traits related to conduct problems both in boys and in girls, although this relationship was higher for boys. To conclude, findings of the present study showed that the Portuguese version of the ICU seems to be a reliable and valid instrument to assess CU traits among children and adolescents in Portugal. However, the original 3-factor model was not supported.

Incidence, recurrence and comorbidity of anxiety disorders in four major developmental stages

BACKGROUND

Anxiety disorders are common in childhood, adolescence, and adulthood, and frequently comorbid with other mental disorders.

OBJECTIVE

The main aim of the present study was to examine the incidence, recurrence and comorbidity rates of anxiety disorders across four developmental periods, namely, during childhood (5 - 12.9 years), adolescence (13 - 17.9 years), emerging adulthood (18 - 23.9 years), and adulthood (24 - 30 years).

METHOD

Eight hundred and sixteen participants from a large community sample were interviewed twice during adolescence, at age 24, and at age 30. They completed self-report measures of psychosocial functioning and semi-structured diagnostic interviews during adolescence and adulthood.

RESULTS

The result showed first incidence of anxiety disorders to be significantly higher in childhood and adulthood than in adolescence and emerging adulthood. Female gender was associated with first incidence, but not with recurrence. Significant comorbidity was found between anxiety disorders and major depressive disorder (MDD) across the four developmental periods. The comorbidity between anxiety and substance use disorders (SUD) was significant in childhood, emerging adulthood and adulthood, but not in adolescence. The presence of anxiety disorders during childhood and adolescence significantly increased the probability of having an anxiety disorder during emerging adulthood.

LIMITATIONS

The participants are ethically and geographically homogenous.

CONCLUSION

Incidence and recurrence rates of anxiety disorders differed across four diverse developmental periods. The magnitude of comorbidity between anxiety disorders and MDD was comparable across periods.

Frequency, Comorbidity, and Psychosocial Impairment of Depressive Disorders in Adolescents

The frequency, comorbidity, and psychosocial impairment of depressive disorders among adolescents was estimated from a survey of 1,035 students aged 12 to 17 years. The adolescents were randomly selected from 36 schools in the province of Bremen, Germany. Depressive disorders and other psychiatric disorders were coded based on DSM-IV criteria using the computerized Munich version of the Composite International Diagnostic Interview. A high proportion of our adolescents met the lifetime criteria for depressive disorders according to DSM-IV criteria, with a rate of 17.9%. Depressive disorders were significantly higher in females than in males. The rates for all of the disorders increased with age, with the greatest increase occurring mostly between the ages of 14 and 15; such increase was more prominent in females than in males. Our results imply the importance of identifying depressive disorders in adolescence and the need for preventive and intervention strategies.

Integrating video-feedback and cognitive preparation, social skills training and behavioural activation in a cognitive behavioural therapy in the treatment of childhood anxiety

BACKGROUND

The present study examined the effectiveness of a transdiagnostic prevention programme, Super Skills for Life (SSL), in children with anxiety problems. SSL is based on the principles of cognitive-behaviour therapy (CBT), behavioural activation, social skills training, and uses video-feedback and cognitive preparation as part of the treatment.

METHODS

Participants were 61 primary school children, aged 8-10 years, who were referred by their teachers as having significant anxiety problems. Children were video-recorded during a 2-min speech task in sessions 1 and 8, and during a social interaction task. All the children completed measures of anxiety symptoms, social skills, and self-esteem before and after participating in the 8-week SSL and at the 6-months follow-up assessment.

RESULTS

Anxiety symptoms were significantly reduced at post-test and follow-up assessments. SSL also had a positive effect on hyperactivity, conduct, and peer problems although it took longer for these effects to occur. Behavioural indicators of anxiety during the 2-min speech task decreased, indicating that the independent raters observed behavioural change in the children from pre-treatment to follow-up. Boys had higher overall behavioural anxiety during the 2-min speech task at all three assessment periods, specifically showing higher lip contortions and leg movement than girls.

LIMITATIONS

The present study used an open clinical trial design, had small sample size, and did not use structured diagnostic interview schedules to assess anxiety disorders.

CONCLUSIONS

This study provides preliminary empirical support for the effectiveness of SSL in children with anxiety problems.

Anxiety disorders in adolescents and psychosocial outcomes at age 30

BACKGROUND

Anxiety disorders are associated with adverse psychosocial functioning, and are predictive of a wide range of psychiatric disorders in adulthood.

OBJECTIVE

The present study examined the associations between anxiety disorders during childhood and adolescence and psychosocial outcomes at age 30, and sought to address the extent to which psychopathology after age 19 mediated these relations.

METHOD

Eight hundred and sixteen participants from a large community sample were interviewed twice during adolescence, at age 24, and at age 30. They completed self-report measures of psychosocial functioning and semi-structured diagnostic interviews during adolescence and young adulthood.

RESULTS

Adolescent anxiety predicted poor total adjustment, poor adjustment at work, poor family relationships, problems with the family unit, less life satisfaction, poor coping skills, and more chronic stress. Adolescent anxiety predicted, substance (SUD), alcohol abuse/dependence (AUD), and anxiety in adulthood. No adult psychopathology mediated the relationship between childhood anxiety disorders and psychosocial outcomes at age 30. Adult, SUD, AUD and anxiety mediated the association between adolescent anxiety and most domains of psychosocial functioning at age 30.

LIMITATIONS

The participants are ethically and geographically homogenous, and changes in the diagnostic criteria and the interview schedules across the assessment periods.

CONCLUSION

Adolescent anxiety, compared to childhood anxiety, is associated with more adverse psychosocial outcomes at age 30. Adolescent anxiety affects negative outcomes at age 30 directly and through adult anxiety, SUD and AUD.

The need for a behavioural science focus in research on mental health and mental disorders

Psychology as a science offers an enormous diversity of theories, principles, and methodological approaches to understand mental health, abnormal functions and behaviours and mental disorders. A selected overview of the scope, current topics as well as strength and gaps in Psychological Science may help to depict the advances needed to inform future research agendas specifically on mental health and mental disorders. From an integrative psychological perspective, most maladaptive health behaviours and mental disorders can be conceptualized as the result of developmental dysfunctions of psychological functions and processes as well as neurobiological and genetic processes that interact with the environment. The paper presents and discusses an integrative translational model, linking basic and experimental research with clinical research as well as population-based prospective-longitudinal studies. This model provides a conceptual framework to identify how individual vulnerabilities interact with environment over time, and promote critical behaviours that might act as proximal risk factors for ill-health and mental disorders. Within the models framework, such improved knowledge is also expected to better delineate targeted preventive and therapeutic interventions that prevent further escalation in early stages before the full disorder and further complications thereof develop. In contrast to conventional "personalized medicine" that typically targets individual (genetic) variation of patients who already have developed a disease to improve medical treatment, the proposed framework model, linked to a concerted funding programme of the "Science of Behaviour Change", carries the promise of improved diagnosis, treatment and prevention of health-risk behaviour constellations as well as mental disorders.

Somatic Symptoms among Children and Adolescents in Poland: A Confirmatory Factor Analytic Study of the Children Somatization Inventory

The aim of the present study was to examine the factor structure and psychometric properties of the short version of the Children's Somatization Inventory (CSI-24) in Poland. The CSI-24 is a self-report questionnaire designed to assess somatic symptoms in children and adolescents. A total of 733 children and adolescents, aged 12-17 years, participated in this research. The participants for this study were recruited from urban and suburban schools of Opole province in South Western Poland. In addition to the CSI-24, all participants completed the Spence Children's Anxiety Scale (SCAS) and the Strength and Difficulties Questionnaire (SDQ). The correlated four-factor model that included four-correlated dimensions (pain/weakness, gastrointestinal problems, cardiovascular symptoms, and pseudoneurological problems) showed a better fit compared to the single-factor model. The Cronbach's Alpha for the CSI-24 was 0.91. Somatic symptoms correlated significantly highly with the SCAS total scores and the SDQ emotional subscale, suggesting good construct validity. Somatic symptoms had low correlation with the SDQ behavioral problems symptoms, suggesting adequate discriminant validity. The CSI-24 reliably measured somatic symptoms in children and adolescents in Poland.

Psychopathological symptoms in two generations of the same family: a cross-cultural comparison

PURPOSE

The main aims of the present study were to compare the frequency and correlates of psychopathological symptoms in two generations of the same family in Japan and in England.

METHODS

The sample included 689 adolescents and one of their parents/guardians. All participants completed a set of questionnaires to measure psychopathological symptoms, self-construals, and perceived social support.

RESULTS

In both parent and adolescent data, the Japanese sample reported significantly lower psychopathological symptoms than the English sample. The relationship between parental and adolescent psychopathology was significant in England, but not in Japan. In both countries, perceived social support and independent self-construal were generally associated with less psychopathological symptoms, and interdependent self-construal was associated with more symptoms. Additionally, in England, a significant interaction effect was found between social support and the self-construals. Participants with low independent and high interdependent self-construal had elevated levels of psychopathological symptoms when perceived social support was low.

CONCLUSIONS

The present study illustrates the importance of culture in the transmission of psychopathological symptoms across different generations in the same family.

Iranian adolescents' ability to recognize depression and beliefs about preventative strategies, treatments and causes of depression

BACKGROUND

Since depression often has its onset during adolescence, knowledge about adolescents' ability to recognize depression and their beliefs about preventative strategies, treatments, and causes of depression are of importance.

METHODS

A total of 1984 adolescents, aged 12-17 years, participated in this study. They were recruited from 16 urban and suburban schools in Ahvaz City, Iran by cluster sampling. Participants were presented with a vignette depicting depression that was developed by Jorm and colleagues.

RESULTS

About half of the adolescents were able to correctly recognize depression. In terms of dealing with the depression depicted by the character in the vignette, older compared to younger participants, thought it best to ignore the individual or keep him/her busy. Younger adolescents were more likely to believe that depression was the result of god's will and a physical illness, whereas older adolescents tended to consider depression as resulting from the way in which people were raised, and from the normal ups and downs of life. Older, compared to younger adolescents, tended to endorse the preventative value of "not using marijuana" and "never drinking alcohol in excess".

LIMITATIONS

Since a hypothetical vignette was used, the findings may not truly reflect the real life experience of depression. The sample was drawn from a single region in Iran.

CONCLUSIONS

Given adolescents' relatively limited knowledge about depression and their beliefs about the causes and preventative strategies, there is fertile ground for health promotion in Iran.

Psychometric Properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in Cypriot Children and Adolescents

The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a 41-item self-report questionnaire that measures symptoms of DSM-IV anxiety disorders (panic/somatic, generalized anxiety, separation anxiety, social phobia) and school phobia in children and adolescents. This study examined the psychometric properties of the Greek translation of SCARED in a large community sample of children and adolescents (N = 1,072), aged 12 to 17 years, in the nonoccupied territory of Cyprus. A subsample of these participants (N = 108) was retested an average of 8 weeks after the initial assessment. The SCARED demonstrated high internal consistency (α = .92) and test-retest reliability (r = .84, over 8 weeks). The SCARED total scores correlated significantly with the internalizing factor of the Youth Self-Report, the Columbia Impairment Scale, and with the emotional subscale of the Strength and Difficulty Questionnaire. Confirmatory factor analyses revealed the same five-factor structure as the original SCARED. The SCARED proved to be a reliable and valid measure of anxiety symptoms in the Cypriot context.