Mental Health Difficulties In Adolescents Research Articles

Child maltreatment during the COVID-19 pandemic: implications for child and adolescent mental health

As societies worldwide addressed the numerous challenges associated with the COVID-19 pandemic, a troubling concern emerged—the possible rise of child maltreatment, which is a pernicious risk factor for child and adolescent mental health difficulties. This narrative review aims to provide a comprehensive understanding of how the many changes and challenges associated with the pandemic influenced worldwide occurrences of child maltreatment and, subsequently, the mental health of children and adolescents. First, we present the well-established evidence regarding the impact of child maltreatment on the mental health of children and adolescents both before and during the COVID-19 pandemic. Next, we examine the existing literature on the prevalence of child maltreatment during the pandemic, explanations for conflicting findings, and key mechanisms influencing the prevalence of maltreatment. Using a heuristic model of child maltreatment and its downstream influence on child mental health, we discuss risk and protective factors for maltreatment as well as mechanisms by which maltreatment operates to influence child and adolescent mental health. Finally, based on the accumulated evidence, we provide important recommendations for advancing research on child maltreatment, emphasizing the necessity for routine monitoring of maltreatment exposure at a population level, and discussing the implications for the field of child protection. This comprehensive review aims to contribute to the understanding of the challenges arising from the intersection of the COVID-19 pandemic and child maltreatment, with the goal of informing effective interventions in the domain of child welfare.

Sex Differences in Autism Symptoms and Mental Health Difficulties in Adolescents with Rare Genetic Disorders

Sex Differences in Autism Symptoms and Mental Health Difficulties in Adolescents with Rare Genetic Disorders

Alexithymia, intolerance to uncertainty and mental health difficulties in adolescents with Type 1 diabetes mellitus

BackgroundType 1 Diabetes Mellitus (T1DM) represents a serious chronic condition affecting a wide number of people. Discussion of the physical issues associated with T1DM pervades the literature, however, there is less discussion of the psychological consequences. Mental health difficulties, alexithymia and uncertainty are present in this population, and known to be harmful for the onset, maintenance and worsening of T1DM. This study aimed to evaluate the presence of these phenomena in people with T1DM.Methods105 participants aged between 11 and 17 years old (M: 13.88; SD: 2.16) affected by T1DM were included in the sample. To assess the presence of mental health difficulties, SAFA scales (Depression, Anxiety and Somatic symptoms) were included in the protocol together with TAS-20 and IUS-12, which evaluate the presence and role of alexithymia and intolerance to uncertainty in the sample, respectively.ResultsA concerning presence of anxiety, depression and somatic symptoms was found in the sample. Mental health difficulties appeared to be consistently present in the sample, often overcoming pathological thesholds. Alexithymia and uncertainty were also common, highlighting their role in T1DM.ConclusionsActive mental health difficulties together with high rates of alexithymia and intolerance to uncertainty were prevalent in the sample of adolescents with diabetes.

Early life risk factors for adolescent mental health difficulties for individuals at risk of developmental language disorder

AbstractYoung people with developmental language disorder (DLD) often have poorer mental health compared to those without DLD. However, not all young people with DLD experience such difficulties. Two hundred and eighty‐one young people at risk of DLD (45% Female; 53% White British) were identified from a UK based population‐cohort. Main caregivers completed questionnaires about their early life (<5 years) and their mental health (at 14 years). Parent–child conflict was revealed to be an early risk factor for all mental health outcomes, at age 14. Additionally, harsh discipline and second‐hand smoke predicted worse externalising problems, and gender differences predicted worse internalising problems. Further findings demonstrated that, as the number of risk factors increased, so did the severity of mental health difficulties.

Network structure of adolescent social, emotional, and behavioral difficulties and their differential relationships with suicidality.

Social, emotional, and behavioral difficulties (SEBDs) tend to develop during adolescence. Their presence and especially co-occurrence induce numerous disrupting consequences, including suicidality. A recently developed network analysis is suitable to investigate the symptom-level structure of comorbid psychopathology. Rather than pairwise comorbidity networks, the current study investigated a comprehensive network of SEBDs at the symptom level and explored the differential relationships between symptoms of SEBDs and suicidality. Recruited from four public schools in China, a sample of adolescents (N = 6974, mean age = 15.84, 50.1% boys) were assessed with the Strengths and Difficulties Questionnaire (SDQ) and one suicidality-related item. The cross-sectional network structure of the SEBD symptoms was investigated. The differential associations between individual symptoms of SEBDs and suicidality were also explored with a relative importance analysis. The results showed that constantly fidgeting, worry a lot, unhappy, down-hearted, tearful, and easily scared emerged as the most central symptoms in the network of SEBDs. Worry a lot, constantly fidgeting, lose my temper, and being bullied served as bridge symptoms, connecting various domains of SEBDs. In addition, the centrality of symptoms was positively associated with the variance shared with suicidality, with worry a lot and unhappy, down-hearted, and tearful explaining a large portion of the variance of suicidality. Taken together, the results were indicative of close connections among emotional, hyperactivity-inattention, peer, and conduct aspects of adolescent mental health difficulties, as well as the central role of emotional difficulties in the SEBDs network.

Adolescent Mental Health Before and During COVID-19: Longitudinal Evidence From the 2004 Pelotas Birth Cohort in Brazil

PurposeThere is great interest in examining the consequences of the COVID-19 pandemic on adolescent mental health, but most studies were conducted in high-income countries. The identification of overall effects and protective factors is essential to understand the determinants of mental wellbeing in contexts of stress. We aimed to study changes in adolescent mental health during the pandemic and the risk and protective factors associated with these changes in a Brazilian birth cohort. MethodsOne thousand nine hundred forty nine adolescents from the 2004 Pelotas Birth Cohort were assessed prepandemic (T1, November 2019 to March 2020, mean age 15.69 years) and mid-pandemic (T2, August to December 2021, mean age 17.41 years). Mental health was assessed using the Strengths and Difficulties Questionnaire. Prepandemic and pandemic-related predictors were examined as predictors of change in multivariate latent change scores models. ResultsThere was a mean increase in adolescent total mental health difficulties (M = 1.071, p < .001), hyperactivity/inattention (M = 0.208, p < .001), emotion symptoms (M = 0.409, p < .001), and peer problems (M = 0.434, p < .001) during the pandemic. This increase was associated with several negative family context variables, including harsh parenting and maternal depressive symptoms at T2. Higher emotion regulation levels protected against increases in adolescent mental health difficulties related to the COVID-19 pandemic. DiscussionFamily-context variables emerged as important risk factors for the deterioration of adolescent mental health during the COVID-19 pandemic. Interventions promoting emotion regulation strategies are a promising approach to protecting adolescent wellbeing in periods of stress.

Student Adaptation, Loneliness and Mental Health Profiles during the Second Wave of the Pandemic COVID-19

Since the COVID-19 pandemic, adolescent mental health difficulties have increased. To understand adolescent adjustment, it is important to explore both mental health difficulties and indicators of resilience and well-being. The primary aim of this study was to explore the associations among resilience, subjective well-being (SWB), fear of COVID-19, and loneliness among adolescents during the second wave of the pandemic. Additionally, the study aimed to identify student profiles based on these variables. The sample consisted of 469 high school students (61% girls, 29% junior high school). Resilience was positively correlated with SWB and negatively with fear of COVID-19 and loneliness. Three student profiles were identified. The Resilient and Satisfied group (38%) consisted of students with the most positive adaptation, and the Average group (41%) involved students with middle scores in all variables, while the Vulnerable and Distressed group (21%) included those who struggled the most. The need for a tiered approach in providing school-based mental health support is discussed.

Time spent on social media among the least influential factors in adolescent mental health: preliminary results from a panel network analysis

There is growing concern about the role of social media use in the documented increase of adolescent mental health difficulties. However, the current evidence remains complex and inconclusive. While increasing research on this area of work has allowed for notable progress, the impact of social media use within the complex systems of adolescent mental health and development is yet to be examined. The current study addresses this conceptual and methodological oversight by applying a panel network analysis to explore the role of social media on key interacting systems of mental health, wellbeing and social life of 12,041 UK adolescents. Here we find that, across time, estimated time spent interacting with social media predicts concentration problems in female participants. However, of the factors included in the current network, social media use is one of the least influential factors of adolescent mental health, with others (for example, bullying, lack of family support and school work dissatisfaction) exhibiting stronger associations. Our findings provide an important exploratory first step in mapping out complex relationships between social media use and key developmental systems and highlight the need for social policy initiatives that focus on the home and school environment to foster resilience. Panayiotou et al. performed a panel network analysis to investigate the relationship between time spent on social media and mental health in a large cohort of UK adolescents.

A qualitative analysis of collaborative efforts to build a school-based intervention for multiple common adolescent mental health difficulties in India.

In low- and middle-income countries (LMICs), the gap between need for mental health (MH) treatment and access to services is stark, particularly among children and adolescents. In service of addressing this treatment gap, the current study provides an in-depth illustration of later-stage collaborative design of a school-based, transdiagnostic MH intervention in New Delhi and Goa, India, using a combination of contextual insights from local stakeholders and knowledge derived from the global evidence base. Using an inductive-deductive approach to qualitative thematic analysis, we examined coded data from qualitative sources related to experiences of developing and implementing an intervention prototype. These sources included notes from meetings attended by treatment development team members and providers, written feedback on protocol materials (e.g., provider manual, student handouts), field notes reflecting researcher observations, and minutes from weekly clinical supervision meetings. Results revealed that codes involving cultural/contextual considerations, protocol material and content, and intervention complexity arose consistently throughout treatment development and across document types, illustrating their central role in finalizing protocol design. These findings have implications for the future of mental health treatment development and implementation globally.

Validation of the Behavioral Anger Response Questionnaire for Children (BARQ-C) in a large community sample of Vietnamese middle adolescents in Hanoi

BackgroundDepression and other forms of psychological distress are common among Vietnamese adolescents and increase the risk of mental health problems in adulthood. As anger coping is a robust predictor of adolescent mental health difficulties, and there appear to be cultural variations in anger coping, a measure of adolescent anger coping styles that has been validated using a non-Western adolescent sample is required to inform and support early intervention to prevent or treat mental health difficulties in Vietnamese adolescents. This study examined the construct validity (structural and external) of the Behavioral Anger Response Questionnaire for Children in Vietnam (BARQC-V).MethodsBaseline data sourced from a recent randomised control trial conducted with Grade 10 Vietnamese adolescents aged 14 to 16 (N = 1084) were used to examine multiple aspects of construct validity: factorial structure (evaluated using factor analysis); internal consistency (tested using Cronbach’s alpha coefficient); and external aspect (assessed using Pearson’s correlation coefficients between the BARQC-V and Vietnamese translations of the Coping Self-Efficacy Scale, Centre for Epidemiologic Studies Depression Scale Revised, Mental Health Continuum Short Form, and the Depression Anxiety and Stress Scale).ResultsEvaluating factorial structure using confirmatory factor analysis failed to converge on a solution. Exploratory factor analysis yielded a 5-factor structure model that explained 49.32% of the BARQC-V’s total variance and was deemed to be a good fit by the final confirmatory factor analysis. Cronbach’s alpha coefficients of the 5 factors demonstrated acceptable internal reliability for the BARQC-V’s sub-scales. Concerning concurrent validity, three sub-scales predicted well-being and mental health difficulties: the maladaptive anger coping styles Rumination and Direct Anger-out were positively associated with depression and distress, and negatively associated with coping self-efficacy and mental well-being; and the adaptive anger coping style Assertion was positively associated with coping self-efficacy and mental well-being, and negatively associated with depression.ConclusionsThe BARQC-V provides a validated measure of three anger coping strategies used by adolescents in Vietnam (Rumination, Direct Anger-out, and Assertion) that can be used to improve detection and treatment of mental health difficulties in this population, and as a starting point by future research to develop a much-needed gold standard measure of anger coping for adults, adolescents and children world-wide.

Adolescent-Reported Household Food Insecurity and Adolescents’ Poor Mental and Physical Health and Food Insufficiency in Kenya

ABSTRACTBackgroundAssessing adolescents’ experiences of food insecurity in households is important for promoting healthy development. Although parental reports have been traditionally used, emerging research highlights the importance of child and adolescent reports of the household food environment.ObjectivesExtending research from high- and upper-middle-income countries, this study of adolescent compared with adult reports of household food insecurity in Kenya, a lower-middle-income country, examined 1) prevalence of and correspondence between adolescent and adult reports of household food insecurity, and 2) associations of adolescent and adult reports of household food insecurity with adolescent nonnutritional and nutritional outcomes.MethodsUsing data from the Kenya Violence Against Children Surveys (n = 1182), we assessed prevalence of household food insecurity reported by adolescents (ages 13–17 y) and adults, with McNemar χ2 and κ analysis of correspondence between reports. Ordinal and binary logistic regression assessed associations between adolescent and adult reports and adolescent mental health and self-rated physical health and food sufficiency outcomes.ResultsHousehold food insecurity was reported by 36% of adolescents and 63% of adults; 36% of adult reports were discordant with adolescent reports (κ = 0.333). Odds of adolescent mental health difficulties were highest with adolescent-only report (OR = 2.11, P = 0.02), followed by adult and adolescent (OR = 1.83, P = 0.001) and adult-only (OR = 1.06, P = 0.77) report. Odds of poor adolescent self-rated physical health were highest with adult and adolescent report (OR = 2.47, P < 0.001) followed by adolescent-only (OR = 2.04, P = 0.08) and adult-only (OR = 1.37, P = 0.20) report. Odds of adolescents eating ≤1 meals the previous day were highest with adult and adolescent (OR = 21.38, P < 0.001) followed by adult-only (OR = 7.44, P = 0.01) and adolescent-only (OR = 2.31, P = 0.34) report.ConclusionsMeasuring household food insecurity with both adolescent report and adult report is important for having a comprehensive understanding of household resources and needs and of the nonnutritional (mental and physical health) and nutritional (diet and food) outcomes of household food insecurity for adolescents.

The impact of the COVID-19 pandemic on adolescent mental health: a natural experiment.

Despite widespread concern about the impact of COVID-19 on adolescent mental health, there remains limited empirical evidence that can causally attribute changes to the pandemic. The current study aimed to overcome existing methodological limitations by exploiting a serendipitously occurring natural experiment within two ongoing, multi-phase cluster randomized controlled trials. Depressive symptoms (primary outcome), externalizing difficulties and life satisfaction (secondary outcomes) were assessed at baseline (phase 1 [pre-COVID-19 group]: September – October 2018, phase 2 [COVID-19 group]: September – October 2019) and 1-year follow-up (pre-COVID-19 group: January – March 2020, COVID-19 group: February – April 2021). Participants in phase 1 (N = 6419) acted as controls. In phase 2, participants (N = 5031) were exposed to the COVID-19 pandemic between the baseline and follow-up assessments providing a natural experimental design. The primary analysis used a random intercept linear multivariable regression model with phase (exposure to the COVID-19 pandemic) included as the key predictor while controlling for baseline scores and individual and school-level covariates. Depressive symptoms were higher and life satisfaction scores lower in the group exposed to the COVID-19 pandemic. Had the COVID-19 pandemic not occurred, we estimate that there would be 6% fewer adolescents with high depressive symptoms. No effect of exposure to the pandemic on externalizing difficulties was found. Exploratory analyses to examine subgroup differences in impacts suggest that the negative impact of the COVID-19 pandemic on adolescent mental health may have been greater for females than males. Given the widespread concern over rising adolescent mental health difficulties prior to the pandemic, this paper quantifies the additional impacts of the pandemic. A properly resourced, multi-level, multi-sector public health approach for improving adolescent mental health is necessary. Following in-principle acceptance, the approved Stage 1 version of this manuscript was preregistered on the OSF at https://doi.org/10.17605/OSF.IO/B25DH. This preregistration was performed prior to data analysis.

A School-Based Approach to Building Resilience and Mental Health Among Adolescents on the Autism Spectrum: A Longitudinal Mixed Methods Study

Tackling mental health difficulties in adolescents on the autism spectrum requires a comprehensive prevention approach. A 3-year multisite proof-of-concept longitudinal study implemented an evidence-based multilevel resilience intervention in schools to promote protective factors at the adolescent, parent, and school level. The intervention, consisting of the adolescent, parent and teacher components of the Resourceful Adolescent Program–Autism Spectrum Disorder (RAP-ASD) augmented with the Index for Inclusion, was implemented in 6 secondary schools with 30 adolescents with an autism diagnosis in Grades 7 and 8, 31 parents of 23 of the adolescents, and school staff. The intervention was implemented with good validity and acceptability. Quantitative data from adolescents and parents were analysed using the Reliable Change Index, and qualitative data were analysed using Consensual Qualitative Research. Triangulated quantitative and qualitative outcomes from the majority of adolescents and their parents showed some evidence for promoting resilience for adolescents with a diagnosis or traits of autism, as reflected in reliable improvements in coping self-efficacy and school connectedness, and a reduction in anxiety symptoms and emotional and behavioural difficulties. A reliable improvement in depressive symptoms was more modest and was only achieved by a small minority of adolescents. This multilevel, strength-focused, resilience-building approach represents a promising and sustainable school-based primary prevention program to improve the quality of life for adolescents on the spectrum by promoting their mental health and providing their families with much needed support.

Engaging Parents of Lower-Socioeconomic Positions in Internet- and Mobile-Based Interventions for Youth Mental Health: A Qualitative Investigation.

Growing literature supports the use of internet- and mobile-based interventions (IMIs) targeting parenting behaviours to prevent child and adolescent mental health difficulties. However, parents of lower-socioeconomic positions (SEP) are underserved by these interventions. To avoid contributing to existing mental health inequalities, additional efforts are needed to understand the engagement needs of lower-SEP parents. This study qualitatively explored lower-SEP parents’ perspectives on how program features could facilitate their engagement in IMIs for youth mental health. We conducted semi-structured interviews with 16 lower-SEP parents of children aged 0–18 to identify important program features. Participants were mostly female (81.3%) and aged between 26 and 56 years. Transcriptions were analysed using inductive thematic analysis. Twenty-three modifiable program features important to lower-SEP parents’ engagement in IMIs were identified. These features aligned with one of three overarching themes explaining their importance to parents’ willingness to engage: (1) It will help my child; (2) I feel like I can do it; (3) It can easily fit into my life. The relative importance of program features varied based on parents’ specific social and economic challenges. These findings offer initial directions for program developers in optimising IMIs to overcome barriers to engagement for lower-SEP parents.

Changes in the adult consequences of adolescent mental ill-health: findings from the 1958 and 1970 British birth cohorts.

Adolescent mental health difficulties are increasing over time. However, it is not known whether their adulthood health and socio-economic sequelae are changing over time. Participants (N = 31 349) are from two prospective national birth cohort studies: 1958 National Child Development Study (n = 16 091) and the 1970 British Cohort Study (n = 15 258). Adolescent mental health was operationalised both as traditional internalising and externalising factors and a hierarchical bi-factor. Associations between adolescent psychopathology and age 42 health and wellbeing (mental health, general health, life satisfaction), social (cohabitation, voting behaviour) and economic (education and employment) outcomes are estimated using linear and logistic multivariable regressions across cohorts, controlling for a wide range of early life potential confounding factors. The prevalence of adolescent mental health difficulties increased and their associations with midlife health, wellbeing, social and economic outcomes became more severe or remained similar between those born in 1958 and 1970. For instance, a stronger association with adolescent mental health difficulties was found for those born in 1970 for midlife psychological distress [odds ratio (OR) 1970 = 1.82 (1.65-1.99), OR 1958 = 1.60 (1.43-1.79)], cohabitation [OR 1970 = 0.64 (0.59-0.70), OR 1958 = 0.79 (0.72-0.87)], and professional occupations [OR 1970 = 0.75 (0.67-0.84), OR 1958 = 1.05 (0.88-1.24)]. The associations of externalising symptoms with later outcomes were mainly explained by their shared variance with internalising symptoms. The widening of mental health-based inequalities in midlife outcomes further supports the need to recognise that secular increases in adolescent mental health symptoms is a public health challenge with measurable negative consequences through the life-course. Increased public health efforts to minimise adverse outcomes are needed.

Adolescent mental health difficulties and educational attainment: findings from the UK household longitudinal study

ObjectiveThis study examines whether there is an independent association between mental difficulties in adolescence and educational attainment at age 16.DesignLongitudinal study.SettingNationally representative data from the UK Household Longitudinal Study (UKHLS)...

The Feasibility of Systemic Interventions for the Prevention and Treatment of Children and Adolescent Mental Health Difficulties in Latin American Countries: A Mixed Studies Systematic Review

This systematic review aims to assess the feasibility of systemic interventions for the prevention and treatment of child and adolescent mental health problems in Latin American countries. A mixed studies systematic review was conducted, and 18 studies were included. Data was synthesized using the framework of Cochrane Qualitative and Implementation Methods Group to build a Best Fit Framework. Stakeholders presented high levels of satisfaction and reported that systemic interventions met the young people’s mental health needs. Barriers to feasibility included lack of collaboration and delays in resource allocation. This review is a valuable resource to systemic intervention developers looking to expand the application of systemic interventions for the prevention and treatment of child and adolescent mental health problems in different cultural settings. Future research is needed to assess the applicability of the study’s innovative methodology to synthesize feasibility outcomes of systemic interventions.Practitioner Points Clinicians and families of young people with mental health problems from Latin American countries felt satisfied with systemic interventions which have a focus on relationships. More support in strengthening community networks was deemed necessary by families in order to consolidate interventions at a family level. Systemic interventions developed in Western countries require considered adaptations when delivered in Latin American Countries.

The role of stigma in children and adolescents with mental health difficulties.

Children and adolescents with mental health difficulties, and people associated with them, can experience stigma as a result of these difficulties. This article aims to provide an update on the literature pertaining to mental health-related stigma in children and adolescents. Recent studies have investigated public stigma, self-stigma and affiliate stigma related to child and adolescent mental health difficulties. Research has typically employed a cross-sectional design. Significant variation was identified in both study methodology and study findings. Qualitative studies offer a unique perspective of stigma from the point of view of the stigmatized individual. Significantly, quantitative analysis has found different variables to be associated with stigma in different geographical locations, even when similar measures are used. Stigma can have a significant detrimental impact on the quality of life for those affected. Careful attention should therefore be paid to stigma in the assessment and treatment of children and adolescents with mental health difficulties. Furthermore, its impact on their caregivers should not be overlooked. Further research is needed to understand the role of social and cultural factors in the development and impact of stigma, and may aid production of antistigma interventions.

The Role of Perceived Social Support in the Relationship Between Being Bullied and Mental Health Difficulties in Adolescents

The aim of the study was to test the relationship between experiences of being bullied, cyberbullied, and mental health difficulties, and whether these relationships are moderated by perceived social support and gender. Data were collected from 3737 year 8 pupils (aged 12 and 13 years; 50.1% male) using an online questionnaire. Measures of bullying victimization, perceived social support, and mental health difficulties were included in the online questionnaire. Moderation analyses were conducted to test whether the relationships between being bullied, cyberbullied, and mental health difficulties were moderated by perceived social support and gender. Four models were estimated, each assessing a different source of perceived social support (from family, friends and peers, professional sources, and the perception of having no support). Results of these analyses indicated that across all four models being bullied was significantly associated with mental health difficulties, and being cyberbullied was only significantly associated with poorer mental health difficulties in girls in one of the models. The different sources of perceived social support did not moderate the relationship between experiences of being bullied or cyberbullied and mental health difficulties for either boys or girls. However, significant associations were found between a perceived lack of support, perceived social support from friends and family, and mental health difficulties in girls, but not in boys. The results contribute to a complex body of research findings exploring the role of perceived social support in the relationship between experiences of being bullied and mental health difficulties.

The Change Clinic Counselling Service: Blending Client-Centred and Strength-Based Practices to Improve Mental Health Services to Families

Operating in a small urban Canadian location, Change Clinic is a brief counselling service intended for child and adolescent mental health issues. It blends principles from different strength-based and client-centred approaches to counselling (e.g., solution-focused, narrative, and single session therapies). Using the parent-report version of the Strengths and Difficulties Questionnaire, changes in child and adolescent mental health difficulties were assessed. Compared to pre-test scores, significant improvements in behavioural, emotional, and hyperactivity problems were observed six months after delivery of the service. Effect size was estimated to be moderate (.62) based on the Added Value Score calculation. Almost three quarters of clients were served in one to two sessions.