Adolescent Mental Health Outcomes Research Articles

Parenting and family interventions in lower and middle-income countries for child and adolescent mental health: A systematic review

BackgroundGiven the protective effect of nurturing caregivers and families for child and adolescent mental health, there is a need to review and synthesize research evidence regarding the effectiveness of parenting and family interventions in low and middle-income countries, including humanitarian settings. To advance practice, further understanding of the active ingredients of such interventions and implementation factors that lead to effectiveness are essential. MethodThis systematic review, an update from a previous review, included studies on any parenting or family intervention for children and adolescents aged 0–24, living in a low- or middle-income country, that quantitatively measured child or adolescent mental health outcomes. We searched Global Health, PubMed, PsychINFO, PILOTS and the Cochrane Library databases on the 9th July 2020, and updated on the 12th August 2022. Risk of bias was assessed using an adapted version of the NIH Quality Assessment Tool. We extracted data on: effectiveness outcomes, practice elements included in effective interventions, and implementation challenges and successes. Main findingsWe found a total of 80 studies (n = 18,193 participants) representing 64 different family or parenting interventions, 43 of which had evidence of effect for a child or adolescent mental health outcome. Only 3 studies found no effect on child, adolescent or caregiver outcomes. The most common practice elements delivered in effective interventions included caregiver psychoeducation, communication skills, and differential reinforcement. Key implementation strategies and lessons learned included non-specialist delivery, the engagement of fathers, and integrated or multi-sector care to holistically address family needs. Preliminary conclusionsDespite a high level of heterogeneity, preliminary findings from the review are promising and support the use of parenting and family interventions to address the wider social ecology of children in low resource and humanitarian contexts. There are remaining gaps in understanding mechanisms of change and the empirical testing of different implementation models. Our findings have implications for better informing task sharing from specialist to non-specialist delivery, and from individual-focused to wider systemic interventions.

Parenting Styles and Mental Health among Adolescents of Nawabshah (SBA), SINDH

Background: Parenting styles are crucial in shaping adolescents' mental health. With varying implications for child development, the authoritative, authoritarian, and permissive parenting styles identified by Baumrind have been subjects of extensive research. The interplay between these parenting approaches and adolescent mental health outcomes remains a pivotal area of inquiry, especially in diverse cultural contexts such as Nawabshah (SBA), Sindh. Objective: This study aimed to identify the predominant parenting styles in SBA and to assess their relationship with the mental health of school-going adolescents. Specifically, it sought to explore the association between authoritative, authoritarian, and permissive parenting styles and the prevalence of depressive symptoms among adolescents. Methods: A descriptive cross-sectional study was conducted with 354 adolescents from both government and private secondary and higher secondary schools in Nawabshah. Participants were selected using non-probability convenience sampling. Data were collected via a survey incorporating the Patient Health Questionnaire (PHQ-9) for assessing mental health and the Parent Authority Questionnaire (PAQ) for evaluating parenting styles. Statistical analysis was performed using SPSS version 25, employing the Pearson correlation coefficient to analyze the relationship between parenting styles and adolescent mental health. Results: The study found a predominance of the authoritative parenting style among participants' parents (56.2%). A significant yet low negative correlation was identified between authoritative parenting and moderate depression in adolescents (r = -.124, p < 0.05). Additionally, combinations of parenting styles were observed, with a notable presence of mixed authoritative-authoritarian practices. Adolescents experiencing authoritative parenting reported higher instances of moderate depression compared to those with other parenting styles. Conclusion: The findings challenge the universally positive portrayal of authoritative parenting, highlighting its complex relationship with adolescent mental health in the SBA context. The study underscores the need for a nuanced understanding of parenting styles and their impact, advocating for culturally sensitive approaches in parenting research.

Association between breakfast consumption, breakfast quality, mental health and quality of life in Turkish adolescents: A high school-based cross-sectional study.

This study aimed to determine the frequency of breakfast consumption and breakfast quality among adolescents and to evaluate the relationships between breakfast consumption, breakfast quality, mental health, and health-related quality of life. This cross-sectional study included 449 students from 17 high schools between December 2022 and May 2023. A face-to-face questionnaire measuring the frequency of breakfast consumption, Mediterranean diet quality index (KIDMED), health-related quality of life (KIDSCREEN), and depression, anxiety and stress scales (DASS-21) was performed. Of the students, 54.1% skipped breakfast 2 or more times a week and 75.9% had poor breakfast quality. There were significant differences in breakfast quality classification according to the frequency of breakfast consumption (p = 0.003). Breakfast consumption ≤1 time/week or 2-5 times/week was associated with depression, anxiety and low adherence to the Mediterranean diet. No relationship was observed between breakfast quality and stress, depression or anxiety (p = 0.620, p = 0.586, p = 0.539, respectively) or between breakfast quality and the KIDSCREEN-27 subscales (p > 0.05). However, those eating poor-quality breakfasts had better results in physical wellbeing (p = 0.022), psychological wellbeing (p = 0.024), autonomy and parent relations (p = 0.017) than breakfast-skippers and also scored lower for depression, stress and anxiety (all p < 0.001). In conclusion, the frequency of breakfast consumption had a stronger association with reduced symptoms of stress, depression and anxiety, as well as improvements in all dimensions of health-related quality of life, compared to the quality of breakfast consumed. Given the association of breakfast consumption with mental health outcomes in adolescents, our findings are of great importance, especially to parents, clinicians and nutritional educators.

COVID-19-related dysfunctional anxiety and associated factors among adolescents in Southwest Ethiopia: a cross-sectional study

BackgroundCOVID-19 pandemic causes serious threats to people’s mental health, particularly it has huge negative mental health outcomes for adolescents. However, there is lack of studies examining COVID-19-related anxiety among adolescents in Ethiopia. Hence, this study was aimed to examine COVID-19-related dysfunctional anxiety and its associated factors among adolescents in Mettu town.MethodsCommunity-based cross-sectional study was conducted from September 1 to 30, 2020 among 847 adolescents selected by stratified sampling technique. IBM SPSS Statistics Version 26.0 was used for analysis. Descriptive statistics such as frequency, percentage, mean, and standard deviation were computed. Bivariate and multivariate binary logistic regression analyses were done to identify factors associated with COVID-19-related dysfunctional anxiety. The statistical significance was declared at p ≤ 0.05; and the strength of association was described in terms of adjusted odds ratio.ResultsOut of the total sample, 819 adolescents participated in this study. The mean age of the participants was 14.9 (SD = 2.798) years. The magnitude of COVID-19-related dysfunctional anxiety was found to be 20.9% (95% CI (18.1, 23.9)). The finding indicates that sex [(AOR (95% CI)); (0.724 (0.502, 1.043))], having both parents deceased [(AOR (95% CI)); (2.981 (1.138, 7.814))], living alone [(AOR (95% CI)); (2.363 (1.050, 5.321))], having unemployed mothers [(AOR (95% CI)); (1.943 (1.194, 3.163))], absence of close friend [(AOR (95% CI)); (0.377 (0.225, 0.630))], and medical problem [(AOR (95% CI)); (0.408 (0.278, 0.597))] were significantly associated with COVID-19-related anxiety.ConclusionThe magnitude of COVID-19-related dysfunctional anxiety was found to be high in the study area. The findings have shown that the likelihood of developing COVID-19-related dysfunctional anxiety was linked to several factors. Provision of continued psychological support for adolescents is extremely encouraged.

The Prevalence of Sexually Transmitted Infections and Subsequent Association with Exposure to Childhood Violence and Mental Health Outcomes for Adolescents and Young Adults in Zimbabwe

Sexually transmitted infections (STIs) represent a major public health concern for young people in developing nations, impacting approximately two-thirds of individuals below the age of 25. This study examined the prevalence and the association between self-reported STIs, childhood violence exposure, and mental health outcomes among adolescents and young adults (13-24 years old) in Zimbabwe. Secondary data from the 2017 Zimbabwe Violence Against Children and Youth Survey (n=8,715) was utilized. Data analysis was performed using chisquare to determine the prevalence estimates for bivariate. Seven logistic regression models were used to examine the significant association between independent variables and outcomes for multivariate. About 45.5% of adolescents and young adults with self-reported STIs were exposed to multiple forms of childhood violence, 49.8% reported lifetime suicide risk, and 44.9% reported moderate-to-severe mental distress in the past 30 days. Furthermore, logistic regression results indicated that adolescents and young adults with self-reported STI diagnoses were more likely to be exposed to multiple forms of childhood violence, including physical, emotional, and sexual violence, as well as mental distress in the past 30 days and lifetime suicide risk compared to those without STIs. Therefore, this study underscores the importance of implementing comprehensive public health strategies to protect the wellbeing of adolescents and young adults with STIs. Interventions should also prioritize raising awareness, destigmatizing STIs, implementing and strengthening violence prevention policies, and addressing mental health problems through community mental health treatment programs in Zimbabwe. Keywords: Childhood violence, Emotional violence, Exposure, Mental distress, Physical violence, Sexual violence, Sexually transmitted infections (STIs), Suicide risk, Zimbabwe.

Using formative research to inform a mental health intervention for adolescents living in Indian slums: the ARTEMIS study

BackgroundAdolescents are vulnerable to stressors because of the rapid physical and mental changes that they go through during this life period. Young people residing in slum communities experience additional stressors due to living conditions, financial stress, and limited access to healthcare and social support services. The Adolescents’ Resilience and Treatment nEeds for Mental Health in Indian Slums (ARTEMIS) study, is testing an intervention intended to improve mental health outcomes for adolescents living in urban slums in India combining an anti-stigma campaign with a digital health intervention to identify and manage depression, self-harm/suicide risk or other significant emotional complaints.MethodsIn the formative phase, we developed tools and processes for the ARTEMIS intervention. The two intervention components (anti-stigma and digital health) were implemented in purposively selected slums from the two study sites of New Delhi and Vijayawada. A mixed methods formative evaluation was undertaken to improve the understanding of site-specific context, assess feasibility and acceptability of the two components and identify required improvements to be made in the intervention. In-depth interviews and focus groups with key stakeholders (adolescents, parents, community health workers, doctors, and peer leaders), along with quantitative data from the digital health platform, were analysed.ResultsThe anti-stigma campaign methods and materials were found to be acceptable and received overall positive feedback from adolescents. A total of 2752 adolescents were screened using the PHQ9 embedded into a digital application, 133 (4.8%) of whom were identified as at high-risk of depression and/or suicide. 57% (n = 75) of those at high risk were diagnosed and treated by primary health care (PHC) doctors, who were guided by an electronic decision support tool based on WHO’s mhGAP algorithm, built into the digital health application.ConclusionThe formative evaluation of the intervention strategy led to enhanced understanding of the context, acceptability, and feasibility of the intervention. Feedback from stakeholders helped to identify key areas for improvement in the intervention; strategies to improve implementation included engaging with parents, organising health camps in the sites and formation of peer groups.Trial RegistrationThe trial has been registered in the Clinical Trial Registry India, which is included in the WHO list of Registries, Reference number: CTRI/2022/02/040307. Registered 18 February 2022.

Ethnic–racial socialization experiences of Mexican American youth

AbstractResearch has shown that ethnic–racial socialization (ERS) predicts education and mental health outcomes for adolescents. However, limited research has evaluated the ERS experiences of Latinx students. The current study examined ERS experiences of Mexican American youth in four focus group interviews that were transcribed and analyzed at both the individual and group level using interpretive phenomenological analysis. Main themes included feeling like an outsider, navigating discrimination, encountering social/emotional difficulties, and achieving a positive identity. Each theme contained two to three subcategories that provide further insight into the Mexican Americans' ERS experiences. Participants reported within‐group discrimination, motivation to disprove stereotypes, and infrequent understanding or compassion from adults. Teachers, administrators, counselors, and school psychologists can attend to and seek to promote social connections, implement social‐emotional learning interventions, foster resilience, work to dismantle racism, collaborate with parents, and create communities of inclusion.

Adolescent School Belonging and Mental Health Outcomes in Young Adulthood: Findings from a Multi-wave Prospective Cohort Study

School belonging, sometimes referred to as school belonging or school connectedness, involves dimensions like positive affect towards school, relationships with teachers, and feeling socially valued. Previous research points to immediate benefits for students’ mental health and wellbeing; however, evidence on the potential long-term benefits of school belonging for mental health—once young people leave the school setting—is limited. This study used data on 1568 adults from the Australian Temperament Project (ATP), a 16-wave longitudinal study which has tracked participants since infancy. The short form of the Australian Council for Educational Research (ACER) School Life Questionnaire was used to assess secondary school belonging at age 15–16 years whilst young adult mental health symptoms were evaluated using the Depression, Anxiety and Stress Scales (DASS-21) at 19–20, 23–24, and 27–28 years. Generalised Estimating Equation models were used to examine the link between secondary school belonging and mental health symptoms in young adulthood. Results showed that higher levels of all aspects of school belonging were associated with lower mental health symptoms across young adulthood (β range − 0.05 to − 0.20). Associations were similar by gender. These findings underscore the importance of adolescent school belonging and in particular school status in reference to feeling socially valued, as a long-term protective factor that can mitigate against later depression, anxiety, and stress.

A pilot randomized control trial on the feasibility, acceptability, and initial effects of a digital-assisted parenting intervention for promoting mental health in Malaysian adolescents.

Online parenting interventions for enhancing child development, specifically mental health is relatively new in Malaysia. This pilot study tests the feasibility, acceptability, and initial effects of a universal digital-assisted parenting intervention (DaPI) in promoting mental health in adolescents by improving parental behaviors and self-efficacy. A two-arm pilot randomized controlled trial was conducted. Twenty-four mothers of adolescent aged 10 to 14 years from a non-clinical sample were recruited online and randomly allocated into two groups (intervention [DaPI] and waitlist-control [WLC]). Eight weekly sessions were delivered online via technological devices. Feasibility outcomes were based on the participants' engagement in DaPI and study retention. Primary (parental behaviors and self-efficacy) and secondary (adolescent mental health) outcomes were assessed using an online survey at baseline (T0), post-intervention (T1), and 1-month follow-up (T2). Data were analyzed using descriptive and inferential statistics and an intention-to-treat approach. The DaPI was well received by the mothers. Retention was high (81.8%) in both groups and intervention adherence was excellent (91.6%). Within-group analyses showed a significant decrease in physical control at T2 and an increase in parental self-efficacy at T1 and T2 among the DaPI mothers. No significant differences were observed in adolescents' mental health at any time point. As for the WLC group, there were no significant differences in all the outcome variables across the three assessment moments. Between groups analyses revealed DaPI mothers had significant differences in proactive parenting at T1, and in positive reinforcement and lax control at T2. There were no significant differences in adolescents' mental health between the groups at any time point. The DaPI is feasible and acceptable in the Malaysian context. Findings show promise regarding the initial effects of the DaPI. However, a larger RCT is needed to determine its effectiveness in promoting mental health of adolescents. https://www.irct.ir/; identifier: IRCT20211129053207N1.

Personalized functional brain network topography is associated with individual differences in youth cognition

Individual differences in cognition during childhood are associated with important social, physical, and mental health outcomes in adolescence and adulthood. Given that cortical surface arealization during development reflects the brain’s functional prioritization, quantifying variation in the topography of functional brain networks across the developing cortex may provide insight regarding individual differences in cognition. We test this idea by defining personalized functional networks (PFNs) that account for interindividual heterogeneity in functional brain network topography in 9–10 year olds from the Adolescent Brain Cognitive Development℠ Study. Across matched discovery (n = 3525) and replication (n = 3447) samples, the total cortical representation of fronto-parietal PFNs positively correlates with general cognition. Cross-validated ridge regressions trained on PFN topography predict cognition in unseen data across domains, with prediction accuracy increasing along the cortex’s sensorimotor-association organizational axis. These results establish that functional network topography heterogeneity is associated with individual differences in cognition before the critical transition into adolescence.

Comorbidity of autism spectrum and attention deficit/hyperactivity disorder symptoms and their associations with 1-year mental health outcomes in adolescents and young adults

Autism spectrum (ASD) and attention deficit/hyperactivity disorders (ADHD) share genetic, neurological, and behavioural features. However, related research in Asia is limited. We collected self-reported ASD and ADHD symptoms from 2186 Hong Kong adolescents and young adults aged 15–24 years, among whom, 1200 provided 1-year data on mental health-related outcomes. Comparative and network analyses were performed. Rating scale cutoff scores were used to divide participants into ASD, ADHD, comorbid, and control groups. The prevalence rates of ASD, ADHD, and comorbidities in Hong Kong were 13.3 %, 10.6 %, and 2.7 %, respectively. Compared with the control group, the comorbid group experienced more psychotic-like experiences (PLEs), the ASD group had poorer functioning, and the ADHD group had higher depression and anxiety symptoms and a lower quality of life after 1 year. The ability to switch attention, preference for routines and difficulty with change, and problems with organisation and planning were positively associated with depressive symptoms, forgetfulness and working memory issues with anxiety symptoms, and heightened sensory input and difficulties in sustaining attention and task completion with PLEs after 1 year. Our findings provide insight into support strategies to address the needs of young Asians to improving their well-being and long-term outcomes.

Reexploring Problematic Social Media Use and Its Relationship with Adolescent Mental Health. Findings from the "LifeOnSoMe"-Study.

Previous approaches used to assess problematic social media use risk inflating prevalence numbers and classifying unproblematic social media use as problematic. The main aim of this study was to take an exploratory view as to how different types of activities, experiences, and motivations on social media are associated with problematic mental health outcomes in adolescents. This study is based on a cross-sectional survey of 2023 adolescents (mean age 17.4 years (SD 0.9), 44.4% males) from the year 2020. Exploratory graph analysis and exploratory factor analysis were performed on 28 pre-selected items assessing adolescents' use of social media, to identify underlying potentially problematic factors associated with social media use. Sets of gender-adjusted multiple linear regression analyses were performed to assess the degree to which social media factors predicted depression, anxiety, well-being, and time spent on social media. Three factors were identified: 1) "subjective overuse", 2) "social obligations", and 3) "source of concern". All three factors showed significant positive associations with mental health problems. The factor "source of concern", which identifies feelings of being overwhelmed and concerned over social media use, had the strongest association to mental health problems and simultaneously the weakest association to time spent on social media. Three identified factors measuring problematic social media use showed positive associations with mental health problems. This lends support to the notion that problematic social media use is a multidimensional phenomenon and demonstrates the need to move beyond addiction criteria when assessing problematic social media use.

Multimodal assessment of circadian sleep health in predicting mental health outcomes in adolescents

IntroductionAspects of circadian sleep health including circadian alignment, circadian phase, or chronotype may be related to mental health outcomes in adolescents. Using novel and robust data collection methods, this study explored the relationship between adolescents' circadian sleep health and traits related to depression, anxiety, stress, and emotional regulation.MethodsFifty-two healthy 14–18-year-olds (58% female; 94% European American) participated in this study. Across a 10-day period, participants completed wrist-worn actigraphy. Next, participants completed a dim-light melatonin onset (DLMO) protocol where 12 saliva samples were collected over a 6-h period to measure circadian phase. Circadian phase was calculated as the duration of time between DMLO to average sleep onset time across the monitoring period. Social jetlag was measured as the discrepancy between sleep times from weekday to weekend. Participants completed the Depression Anxiety Stress Scales (DASS-21), Emotion Regulation Questionnaire (ERQ), and the Morningness-Eveningness Questionnaire for Adolescents (MEQ). Following dichotomizing sleep outcomes into clinically relevant groups (late vs. early circadian phase, aligned vs. misaligned circadian rhythms, minimal social jetlag vs. presence of social jetlag, intermediate to morningness vs. eveningness chronotype), we conducted general linear models to determine circadian group differences in mental health outcomes (depression, anxiety, stress, expressive suppression, and cognitive reappraisal) while controlling for gender and pubertal development.ResultsCircadian phase had a large effect on depression symptoms in adolescents, with adolescents with later DLMO having significantly higher depression scores than those with earlier DLMO (p = 0.031). Chronotype had a medium but non-significant effect on anxiety and stress symptoms in adolescents, with adolescents with eveningness-tendencies having higher anxiety and stress symptoms than those with intermediate to morningness-tendencies (p's = 0.140 and 0.111, respectively).ConclusionsIn the first ever study using gold-standard methodologies to examine the relationship between mental health and circadian sleep health in healthy adolescents, we observed that adolescents with later circadian phase had increased depressive symptoms compared to earlier circadian phase. Furthermore, adolescents who endorsed behaviors that suggest eveningness tendencies may have heightened stress/anxiety. These conclusions encourage future experimental research regarding this topic and may help inform interventions aimed to decrease depression, anxiety, and stress in adolescents.

Longitudinal Effects of Elexacaftor/Tezacaftor/Ivacaftor: Multidimensional Assessment of Neuropsychological Side Effects and Physical and Mental Health Outcomes in Adolescents and Adults

Italy initiated Elexacaftor/Tezacaftor/Ivacaftor (ETI) for people with cystic fibrosis (pwCF) in July 2021. It has been led to dramatic improvements in lung function, BMI, sweat chloride, and respiratory symptoms. However, little data is available on side-effects or effects on a broad range of outcomes. How does ETI affect mental health, cognitive processing, neuropsychological side-effects, GI symptoms, and HRQoL over time? AND METHODS This was a prospective, "real world" longitudinal study. Participants were recruited consecutively and evaluated at initiation T0 and after 1-month (T1), 3-months (T2), and 6-months (T3). Assessments included depression (PHQ-9), anxiety (GAD-7), cognition (SDMT), GI Symptom Tracker, and HRQoL (CFQ-R). Based on literature, an ad-hoc questionnaire was developed to assess side-effects: insomnia, headache, memory problems, "brain fog" and concentration problems. Following descriptive analyses, longitudinal data were analyzed using mixed models for repeated measures (MMRM), controlling for age and gender when appropriate. Ninety-two consecutive pwCF (F/M=46/46; age M=25.4 years) participated. FEV1 increased initially then remained stable. BMI also increased significantly from T0 to T3 (p<0.01). Depression improved from T0 to T1 (p<0.001), however no changes in anxiety were found. Cognitive processing improved from T0 to subsequent assessments. Positive changes were reported on the GI Symptom Tracker for Stools and Adherence Challenges, however, no changes were found for Abdominal Pain and Digestion. Side-effects occurred in 10%-29%, with no reduction over time; insomnia increased significantly across time. Women reported more side-effects than men (i.e., insomnia, headache, concentration problems, brain fog). This prospective study evaluated the effects of ETI using multiple measures. Significant improvements were found in many domains, however, side-effects were reported by a substantial proportion of pwCF, with no improvements over time. Women reported more side-effects than men. PwCF should be followed systematically to assess the frequency of side-effects after starting this new modulator.

Reexploring problematic social media use and the relationship with adolescent mental health

Abstract Background Previous approaches used to assess problematic social media use risk inflating prevalence numbers and classify unproblematic social media use as addictive or problematic. The main aim of this study was to take an exploratory view as to how different types of activities, experiences, and motivations on social media are associated with problematic mental health outcomes in adolescents. Methods This study is based on a cross-sectional survey of 2023 adolescents (mean age 17.4 years (SD 0.9), 44.4 % males) from 2020. Exploratory graph analysis, Mokken scaling analysis and confirmatory factor analysis were performed on 28 pre-selected items assessing adolescents’ activities, experiences, and motivations on social media, to identify underlying potentially problematic factors associated with social media use. Sets of gender-adjusted multiple linear regression analyses were performed to assess the degree to which social media factors predicted depression, anxiety, well-being, and time spent on social media. Results Three factors were identified and named: 1) ‘subjective overuse’, 2) ‘social obligations’, and 3) ‘source of concern’. All three factors showed significant positive associations with mental health problems. The factor ‘source of concern’, which identifies feelings of being overwhelmed and concerned over social media use, had the strongest association to mental health problems and simultaneously the weakest association to time spent on social media. Conclusions Three identified factors measuring problematic social media use showed positive associations with mental health problems. This lends support to the notion that problematic social media use is a multidimensional phenomenon. Key messages • Being overwhelmed and concerned over social media use had the strongest association to mental health problems and simultaneously the weakest association to time spent on social media. • The results from this study lends support to the notion that problematic social media use is a multidimensional phenomenon.

Negative experiences on social media and mental health among adolescents. The “LifeOnSoMe”-Study

Abstract Background Cyberbullying has been widely studied and is associated with poor mental health outcomes in adolescents. However, adolescents frequently also experience a range of other negative experiences, such as name-calling, exclusion, and unwanted attention or contact from others. Few previous studies have investigated how adolescents’ mental health is affected by these more common and relatively less severe types of negative experiences on social media (SOME). The aim of the present study was to assess the associations between mental health outcomes and two aspects of negative experiences on SOME; unwanted attention and negative acts and exclusion. Methods This study is based on a survey conducted in 2020/21 consisting of 3,253 Norwegian adolescents (mean age 17 years; 56% female). Eight statements about negative experiences on SOME were asked and combined into two composite measures: “Unwanted attention from others” and “Negative acts and exclusion”. Dependent variables in regression models were symptoms of anxiety, symptoms of depression, and quality of life. Covariates included age, gender, subjective socioeconomic status, and amount of SOME-use. Results Both “negative acts and exclusion” and “unwanted attention from others” on SOME were consistently positively associated with self-reported symptoms of depression and anxiety, and negatively associated with mental well-being in both crude and adjusted analysis. Conclusions The results indicate a potential important relationship between experiencing negative events on SOME, even presumably less severe events, and worse mental health and well-being. Future research should investigate the potential causal relationship between negative experiences on SOME and mental health, as well as exploring potential precipitating and intermediating factors. Key messages • The findings from this study indicate that commonly reported negative experiences on social media is associated with poor mental health and well-being among adolescents. • The present study highlight the need to also focus on less severe but commonly occuring negative experiences on social media.

A growth mindset intervention to improve mental health in adolescents during COVID‐19

AbstractCOVID‐19 poses a considerable threat to adolescent mental health. We investigated depression rates in teens from pre to post‐COVID. We also explored if leveraging a growth mindset intervention (“Healthy Minds”) could improve adolescent mental health outcomes during the pandemic, especially for adolescents experiencing the most distress. In Study 1, we recruited youth from schools in a rural southern community (N = 239) and used a pre‐post design. In Study 2, we recruited an online sample (N = 833) and used a longitudinal randomized control trial design to test the effectiveness of Healthy Minds. Across both studies, there is evidence of higher rates of depression in youth during COVID‐19, relative to pre‐pandemic numbers. In Study 1, the intervention effectively changed psychological and behavioral processes related to mental health, especially for adolescents experiencing greater COVID‐19 stress. However, in Study 2, the intervention failed to impact depression rates or symptoms at follow‐up.

Current evidence and opportunities in child and adolescent public mental health: a research review.

A public mental health lens is increasingly required to better understand the complex and multifactorial influences of interpersonal, community and institutional systems on the mental health of children and adolescents. This research review (1) provides an overview of public mental health and proposes a new interactional schema that can guide research and practice, (2) summarises recent evidence on public mental health interventions for children and adolescents, (3) highlights current challenges for this population that might benefit from additional attention and (4) discusses methodological and conceptual hurdles and proposes potential solutions. In our evidence review, a broad range of universal, selective and indicated interventions with a variety of targets, mechanisms and settings were identified, some of which (most notably parenting programmes and various school-based interventions) have demonstrated small-to-modest positive effects. Few, however, have achieved sustained mental health improvements. There is an opportunity to re-think how public mental health interventions are designed, evaluated and implemented. Deliberate design, encompassing careful consideration of the aims and population-level impacts of interventions, complemented by measurement that embraces complexity through more in-depth characterisation, or 'phenotyping', of interpersonal and environmental elements is needed. Opportunities to improve child and adolescent mental health outcomes are gaining unprecedented momentum. Innovative new methodology, heightened public awareness, institutional interest and supportive funding can enable enhanced study of public mental health that does not shy away from complexity.

Interventions to reduce wait times for adolescents seeking mental health services: a scoping review protocol

IntroductionThe demand for adolescent mental health services has increased significantly in recent years, leading to excessive wait times for adolescents seeking mental health services and poor mental health outcomes. Timely...

Examining the effects of cumulative environmental stressors on Gulf Coast child and adolescent health.

This study examines how community-level cumulative environmental stress affects child and adolescent emotional distress and chronic health conditions both directly and indirectly through stressors at the household, family, and individual levels. Data comes from the Women and their Children's Health (WaTCH) Study, which sought to understand the health implications of exposure to the 2010 Deepwater Horizon oil spill (DHOS) among a cohort of 596 mothers with children ages 10 to 17 in southeastern Louisiana. Community-level environmental stress was measured using a newly developed geospatial index. Household-level stressors included previous hurricane impacts, impacts of DHOS, degree of financial difficulty, and degree of housing physical decay. Family stressors included maternal depression, self-rated physical health, and degree of parenting stress. Child stress was based on perceived stress; child mental health was based on serious emotional disturbance; and child physical health was based on diagnosis of chronic illness. Structural equation modeling used weighted least squares means and variance and theta parameterization. Results showed a significant negative direct path between community-level cumulative environmental stress and child/adolescent serious emotional disturbance and chronic illness. However, the indirect relationship through household, family, and individual-level stressors was significant and positive for both child/adolescent serious emotional disturbance and chronic illness. These findings point to the centrality of the household and family in determining child and adolescent physical and mental health outcomes in communities exposed to frequent disasters and ongoing environmental stressors.