Adolescent Psychopathology Research Articles

3.97 Development of a Transdiagnostic, Resilience-Focused Intervention for At-Risk Adolescents

Environmental adversity and subclinical symptoms of psychopathology in adolescents increase their risk for the development of a future psychiatric disorder, yet interventions that may prevent poor outcomes in these vulnerable adolescents are not widely available. Our objectives were to develop and test the feasibility and acceptability of a prevention-focused program to enhance resilience in high-risk adolescents.

Does Time Spent Online Affect Future Psychopathology in Adolescents?

Abstract. Theoretical background: In cross-sectional studies, high levels of online time proved to be empirically related to a higher risk of online behavioral addictions, which in turn are cross-sectionally and longitudinally associated with psychopathology. First results indicated that online behavioral addictions could predict a higher psychopathological burden. Objective: We empirically examined whether online time is also a predictor of future psychopathology in youth. Methods: In a longitudinal study, we explored whether 249 adolescents (55.0 % girls, aged 15.31 years, SD = 1.78) were at increased risk for problematic Internet use at baseline (t1) and 12-month later (t2) using standardized questionnaires regarding psychopathology (SDQ), online behavioral addictions (CIUS), and time spent online. Results: In linear regression analyses, online time was not a statistically significant predictor of any psychopathological burden 12 months later (at t2), after controlling for gender, age, online behavioral addictions, and respective symptoms of psychopathology (all at t1). Discussion and conclusion: Time spent online does not seem to predict future psychopathological strain during adolescence.

Emotional Reactivity to Daily Family Conflicts: Testing the Within-Person Sensitization.

Although the sensitization hypothesis posits that heightened reactivity to interparental conflict is linked to adolescent psychopathology, limited studies tested whether sensitization would emerge in parent-adolescent conflict and across ethnicity or culture. This study revisits the sensitization hypothesis by examining adolescent emotional reactivity to interparental and parent-adolescent conflicts on a daily timescale. The sample included 163 adolescents (55% girls; Mage = 12.79) and their parents (78% females; Mage = 45.46) who completed a 10-day reports in Taiwan. Multilevel modeling results showed that, instead of interparental conflict, adolescents with greater histories of parent-adolescent conflict exhibited higher emotional reactivity when parent-adolescent conflict was higher. The findings underscore the importance of parent-adolescent conflict in evaluating adolescent developmental risk.

Parent- and teacher-reported associations from adolescent bifactor models of psychopathology: an outcome-wide association study of 26 outcomes in mid-life.

Adolescent mental health problems have lasting impacts on health and social functioning later in life. Evidence to date mostly comes from studies of specific diagnostic categories/dimensions, but hierarchical models can elucidate associations with general as well as specific dimensions of psychopathology. We provide evidence on long-term outcomes of general and specific dimensions of adolescent psychopathology using both parent and teacher reports. Parents and teachers from the Isle of Wight study completed Rutter behaviour scales when participants were 14-15 years old (n = 2,275), assessing conduct, emotional and hyperactivity problems. Metric-invariant bifactor models for parents and teachers were used to test domain-specific and domain-general associations with 26 self-reported psychosocial outcomes at mid-life (age 44-45 years, n = 1,423). Analyses examined the individual and joint contributions of parent and teacher reports of adolescent psychopathology. All analyses were adjusted for covariates (gender, IQ and family social class) and weighted to adjust for the probability of nonresponse. Parent- and teacher-reported general factors of psychopathology (GFP) were associated with 15 and 12 outcomes, respectively, across the socioeconomic, relationship, health and personality domains, along with an index of social exclusion. Nine outcomes were associated with both parent- and teacher-reported GFP, with no differences in the strength of the associations across reporters. Teacher-reported specific factors (conduct, emotional and hyperactivity) were associated with 21 outcomes, and parent-reported specific factors were associated with seven. Five outcomes were associated with the same specific factors from both reporters; only one showed reporter differences in the strength of the associations. These findings confirm the relevance of the GFP and the utility of teacher as well as parent reports of adolescent mental health in predicting psychosocial outcomes later in the life course.

Familial and Bullying Victimisation: The Impact of Early Adversity Within the Home and Peer Settings on Late Adolescence and Adult Psychopathology

BackgroundAwareness of adverse childhood experiences and their impact on adult psychopathology primarily focuses on adversities within the home. There is limited insight into the impact of adversities across peer environments.ObjectiveThis study investigates 19 items related to adverse experiences across the home, school and peer environments and their relationship to 12-month and lifetime psychopathology.DataSecondary analysis of the Ulster University Student Well-being Study. The dataset included completed responses across all selected variables for 729 participants.Method and ResultsLatent profile analysis identified a low adversity profile, bullying adversity profile and higher prevalence adversity profile. Regression analysis of the three profiles and demographics variables indicated their impact on adult psychopathology lifetime and 12-month prevalence rates.ConclusionSchools and HE institutions should acknowledge the impact of childhood adversities. In doing so, it is important to consider the deeper impact of bullying due to its links with psychopathology across the lifespan. Educational institutions should take appropriate steps to mitigate continued exposure as students’ progress through the education system.

Differential Associations of Adversity Profiles with Adolescent Cognitive Control and Psychopathology.

Adverse childhood experiences are common and have long-term consequences for biological and psychosocial adjustment. We used a person-centered approach to characterize distinct profiles of adversity in early adolescence and examined associations with later cognitive control and psychopathology. The sample included 167 adolescents (47% female) and their primary caregivers who participated in a longitudinal study across four time points (approximately one year between assessments). At Time 1 (Mage = 14years), we measured seven indicators of adversity: socioeconomic disadvantage, abuse, neglect, household chaos, parent substance use, parent depression, and negative life events. At Times 2-4, adolescents' behavioral performance and functional activation during a cognitive control task were measured. At Time 5, adolescents and their caregiver reported on adolescent internalizing and externalizing symptomatology. Using latent profile analysis, we identified four distinct adversity subgroups: a low exposure group, a neglect group, a household instability group, and a poly-adversity group. These groups significantly differed on subsequent levels of psychopathology, but not cognitive control. Specifically, the poly-adversity group reported significantly higher levels of both internalizing and externalizing symptomatology relative to the low exposure group, and the household instability group demonstrated elevated risk for externalizing symptomatology. When using a cumulative risk approach, higher levels of adversity exposure were associated with significantly worse cognitive control performance (but not neural activation). These results suggest that psychopathology outcomes may be differentially predicted by distinct patterns of risk, and that cognitive control impairment may be more strongly predicted by cumulative risk.

Problematic Internet Use Among Adolescent Male and Female Psychiatric Inpatients: A Gender Perspective

Problematic internet use (PIU) is of treatment interest in adolescent clinical samples. Gender specific differences in terms of personality traits and psychopathological symptoms remain unclear. In an adolescent clinical sample (n = 104; 69 girls) PIU, psychopathology, temperament and character traits as well as emotional and behavioral problems were assessed. 62% of the sample showed subthreshold PIU and 34% full PIU (fPIU). Boys reported more gaming whereas girls social networking. Sex specific analyses revealed gender differences: Girls with fPIU scored significantly higher on internalizing/externalizing problems/behavior, novelty seeking and transcendence, and lower on persistence, self-directedness, and cooperativeness than girls without fPIU. Boys with fPIU scored significantly higher on internalizing problems and self-transcendence and lower on harm avoidance than boys without fPIU. Gender plays an important role in PIU. Gender specific differences in both application use as well as symptomatic, temperament and character traits call for a gender specific approach in prevention and treatment integration.

Exposure to Violence as an Environmental Pathway Linking Low Socioeconomic Status with Altered Neural Processing of Threat and Adolescent Psychopathology.

Low childhood socioeconomic status (SES) is associated with increased risk for psychopathology, in part because of heightened exposure to environmental adversity. Adverse experiences can be characterized along dimensions, including threat and deprivation, that contribute to psychopathology via distinct mechanisms. The current study investigated a neural mechanism through which threat and deprivation may contribute to socioeconomic disparities in psychopathology. Participants were 177 youths (83 girls) aged 10-13 years recruited from a cohort followed since the age of 3 years. SES was assessed using the income-to-needs ratio at the age of 3 years. At the age of 10-13 years, retrospective and current exposure to adverse experiences and symptoms of psychopathology were assessed. At this same time point, participants also completed a face processing task (passive viewing of fearful and neutral faces) during an fMRI scan. Lower childhood SES was associated with greater exposure to threat and deprivation experiences. Both threat and deprivation were associated with higher depression symptoms, whereas threat experiences were uniquely linked to posttraumatic stress disorder symptoms. Greater exposure to threat, but not deprivation, was associated with higher activation in dorsomedial pFC to fearful compared with neutral faces. The dorsomedial pFC is a hub of the default mode network thought to be involved in internally directed attention and cognition. Experiences of threat, but not deprivation, are associated with greater engagement of this region in response to threat cues. Threat-related adversity contributes to socioeconomic disparities in adolescent psychopathology through distinct mechanisms from deprivation.

Consistency and source specificity of symptom ratings for Child and Adolescent Behavior Inventory Scales with mother, father, and teacher ratings of Spanish children.

The study determined consistency relative to a reference source (convergent validity for nonreference sources with a reference source) and specificity for nonreference sources in true score variance in Child and Adolescent Behavior Inventory (CABI) ADHD-inattentive (IN), ADHD-hyperactive/impulsive (HI), sluggish cognitive tempo (SCT), oppositional defiant disorder (ODD), limited prosocial emotions (LPE), depression, anxiety, academic impairment, and social impairment scale scores. A multiple indicator by single trait by correlated (methods-1) model with indicator-specific trait factors was used to evaluate CABI scale scores with mother, father, and teacher ratings of 2,142 Spanish children (49.49% girls; ages 8-13). Mother ratings served as the reference source with father and teacher ratings serving as nonreference sources. Father with mother ratings showed substantial convergent correlations for each CABI scale (.73 to .90). Teacher with mother ratings showed a substantial convergent correlation for academic impairment (.72), strong convergent correlations for ADHD-IN (.57), ADHD-HI (.46), SCT (.52), and depression (.46), and small-to-moderate convergent correlations for ODD (.33), LPE (.24), and anxiety (.22) scales. Source independent and context-specific measures with appropriate content validity for home and school settings are required to better understand the greater variability in consistency from teacher to mother ratings. These results provide new information for the use of the CABI with multiple sources. In addition, the study indicates how a multiple indicator by single trait by correlated (methods-1) model with indicator-specific trait factors can be used to better understand multiple source ratings of child and adolescent psychopathology and adjustment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Tonic and phasic irritability in 6-year-old children: differential correlates and outcomes.

Irritability is a common and clinically important problem in children and adolescents and a risk factor for later psychopathology and impairment. Irritability can manifest in both tonic (e.g., irritable, touchy mood) and phasic (e.g., temper outburst) forms, and recent studies of adolescents suggest that they predict different outcomes. However, no studies have examined whether tonic and phasic irritability are empirically distinguishable in 6-year-old children and whether they have distinct correlates and outcomes. We utilized data from a longitudinal study of an unselected community sample of four hundred fifty-two 6-year-olds followed at 3-year intervals to age 15. We conducted confirmatory factor analysis (CFA) using relevant items from a diagnostic interview and several parent-report inventories. The CFA identified dimensions that were consistent with tonic and phasic irritability. Tonic irritability was independently associated with concurrent parent-reported temperamental negative affectivity and internalizing and externalizing disorders at age 6 and predicted higher rates of internalizing psychopathology, and suicidal ideation, in adolescence. Phasic irritability was independently associated with concurrent parent-reported temperamental negative affectivity, surgency, and low effortful control, maladaptive parenting styles and practices, and externalizing disorders at age 6, and predicted higher rates of externalizing psychopathology in adolescence. Tonic and phasic irritability in 6-year-old children appear to be distinguishable constructs with different temperament and parenting correlates and psychopathological outcomes. Distinguishing these components has implications for research on the etiology and pathophysiology of irritability and developing effective treatments.

Salud mental en la adolescencia (I). Ansiedad y depresión

Anxiety disorders are the most prevalent mental health disorders in childhood and adolescence. Major depression is also one of the most prevalent illnesses and its severity makes it especially important. Comorbidity between anxiety and depression disorders is one of the most common phenomenons in the psychopathology of adolescents; different epidemiological studies have reported a prevalence of between 30% and 75%.In order to conduct a comprehensive interview and examination, it is essential to have information provided by the parents, other caregivers, and teachers. Though the diagnosis in childhood and adolescence is clinical, there are a series of scales that can contribute to detection symptoms and also facilitate its longitudinal monitoring.The treatment of choice for both depression and anxiety disorders is a combination of psychotherapy and psychopharmacological treatment. Accompaniment and follow-up by the pediatrician during childhood and adolescence is very important.

Adolescent Mental Health and Family Economic Hardships: The Roles of Adverse Childhood Experiences and Family Conflict.

Rising and economically disproportionate rates of adverse mental health outcomes among children and youth warrant research investigating the complex pathways stemming from socioeconomic status. While adverse childhood experiences (ACEs) have been considered a possible mechanism linking socioeconomic status (SES) and child and youth psychopathology in previous studies, less is understood about how family environments might condition these pathways. Using data from a longitudinal, multiple-wave study, the present study addresses this gap by examining the direct relationships between family economic status and youth internalizing and externalizing symptoms, if ACEs mediate these relationships, and if conflictual family environments moderate these direct and indirect relationships. The data were obtained from 5510 youth participants [mean age at baseline = 9.52 (SD = 0.50), 47.7% female, 2.1% Asian, 10.3% Black, 17.6% Hispanic, 9.8% Multiracial/Multiethnic, 60.2% White] and their caretakers from the baseline, 1-year, and 2-year follow up waves. Conditional process analysis assessed the direct, indirect, and moderated relationships in separate, equivalent models based on youth- versus caregiver-raters of ACEs and youth psychopathology to capture potential differences based on the rater. The results of both the youth- and caregiver-rated models indicated that lower family economic status directly predicted higher levels of externalizing symptoms, and ACEs indirectly accounted for higher levels of internalizing and externalizing symptoms. Additionally, family conflict moderated some, but not all, of these relationships. The study's findings highlight that lower family economic status and ACEs, directly and indirectly, contribute to early adolescent psychopathology, and conflictual family environments can further intensify these relationships. Implementing empirically supported policies and interventions that target ACEs and family environments may disrupt deleterious pathways between SES and youth psychopathology.

Lower emotional complexity as a prospective predictor of psychopathology in adolescents from the general population.

Emotional complexity (EC) involves the ability to distinguish between distinct emotions (differentiation) and the experience of a large range of emotions (diversity). Lower EC has been related to psychopathology in cross-sectional studies. This study aimed to investigate (a) whether EC prospectively predicts psychopathology and (b) whether this effect is contingent on stressful life events. To further explore EC, we compared the effects of differentiation and diversity. Adolescents from the general population (N = 401) rated 8 negatively valenced emotions 10 times a day for 6 consecutive days. Further, they completed the Symptom Checklist-90 (baseline and 1-year follow-up) and a questionnaire on past year's life events at follow-up. Logistic regression analyses tested whether EC-reflected by emotion differentiation (intraclass correlation coefficient [ICC]) and diversity (diversity index [DI])-predicted prognosis (good: remitting or lacking symptoms vs. bad: worsening or persisting symptoms). EC predicted prognoses but only when based on the ICC (OREC.ICC = 1.42, p = .02). An ECICC 1 SD above average increased the probability of good prognosis from .67 to .74. This effect was not related to stressful life events (OREC × Life events = 1.03, p = .86) and disappeared when emotion intensity (mean level) was taken into account (OREC = 1.20, p = .20). Predicting future prognosis does not necessitate complex measures of emotional experience (ICC, DI) but rather might be achieved through simpler indices (mean). The discrepant effects of the ICC and DI on prognosis suggest that impaired emotion representation (ICC) plays a more important role in vulnerability to mental ill health than does low diversity of emotions (DI). (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Modeling sensitivity to social threat in adolescent girls: A psychoneurometric approach.

The Research Domain Criteria (RDoC) project's success rests on the assumption that constructs and data can be integrated across units of analysis and developmental stages. We adopted a psychoneurometric approach to establish biobehavioral liability models of sensitivity to social threat, a key component of potential threat that is particularly salient to the development of adolescent affective psychopathology. Models were derived from measures across four units of analysis in a community sample (n = 129) of 11- to 13-year-old girls oversampled for shy/fearful temperament. To test the ecological validity of derived factors, they were then related to real-world socioaffective processes in peer interactions over a 16-day ecological momentary assessment (EMA) protocol. Our results indicate that measures (i.e., amygdala reactivity to negative social feedback, eye-tracking bias toward social threat, parent- and adolescent-reports of social threat sensitivity) formed unit-specific factors, rather than one unified factor. These findings suggest that these factors were largely unrelated. Amygdala response to social punishment and attention bias toward threatening faces predicted real-world experiences with peers, suggesting that vigilance toward potentially threatening social information could be a mechanism through which vulnerable youth come to experience their peer interactions more negatively. We discuss measurement challenges confronting efforts to quantify developmentally sensitive RDoC constructs across units of analysis. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The role of threat anticipation in the development of psychopathology in adolescence: findings from the SIGMA Study.

Childhood adversity is associated with psychopathology. First evidence in adults suggests that threat anticipation, i.e., an enhanced anticipation of unpleasant events creating an enduring sense of threat, may be a putative mechanism linking childhood adversity to psychopathology. This study aimed to test the indirect effect of childhood adversity on psychopathology via threat anticipation in a large community sample of adolescents. We measured childhood trauma and bullying victimization (as indicators of childhood adversity), threat anticipation, general psychopathology and prodromal psychotic symptoms in adolescents aged 12-16years (full sample size N = 1682; minimum sample size in the complete case sample N = 449) in wave I of the SIGMA study. We found strong evidence that childhood adversity (e.g. childhood trauma, adj. β (aβ) = 0.54, p < .001) and threat anticipation (e.g. aβ = 0.36, p < .001) were associated with general psychopathology and prodromal psychotic symptoms. Moreover, there was evidence that the association between childhood adversity, general psychopathology and prodromal psychotic symptoms is mediated via pathways through threat anticipation (e.g. childhood trauma, aβindirect effect = 0.13, p < .001). Threat anticipation may be a potential mechanism linking childhood adversity and psychopathology in adolescents.

The persistent effects of foetal growth on child and adolescent mental health: longitudinal evidence from a large population-based cohort.

Low birth weight for one's gestational age is associated with higher rates of child psychopathology, however, most studies assess psychopathology cross-sectionally. The effect of such foetal growth restriction appears to be strongest for attention problems in childhood, although adult studies have found associations with a range of outcomes, from depression to psychosis. We explore how associations between foetal growth and psychopathology change across age, and whether they vary by sex. We used a large nationally representative cohort of children from Ireland(N ~ 8000). Parents completed the Strengths and Difficulties Questionnaire (SDQ) at 3 time points (age 9, 13 and 17). Outcomes included a total problems scale and subscales measuring attention/hyperactivity, peer, conduct and emotional problems. Foetal growth had significant associations with all problem scales, even after controlling for sex, socioeconomic factors and parental mental health. The magnitude of these effects was small but relatively stable across ages 9-17. In males, foetal growth had the strongest associations with attention/hyperactivity and peer problems, whereas females showed more widespread associations with all four subscales. There was a trend for the association between foetal growth and emotional problems to increase with advancing age, approaching the borderline-abnormal threshold by age 17. Reduced foetal growth predicted persistently higher scores on all measured aspects of child and adolescent psychopathology. Associations with child attention/hyperactivity may generalize to a wider array of adult psychopathologies via adolescent-onset emotional problems. Future studies should explore potential age-dependent effects of foetal growth into the early 20s.

Child and Adolescent Sleep Disturbances and Psychopathology in a Mental Health Clinic Sample

Child and Adolescent Sleep Disturbances and Psychopathology in a Mental Health Clinic Sample

Interindividual variability in functional connectivity discovers differential development of cognition and transdiagnostic dimensions of psychopathology in youth

Cognitive and psychological development during adolescence is different from one another, which is rooted in individual differences in maturational changes in the adolescent brain. This study employed multi-modal MRI data and characterized interindividual variability in functional connectivity (IVFC) and its associations with cognition and psychopathology using the Philadelphia Neurodevelopmental Cohort (PNC) of 755 youth. We employed resting state functional MRI (rs-fMRI) and diffusion weighted images (DWIs) to estimate brain structural and functional networks. We computed the IVFC of individuals and examined its relation with structural and functional organizations. We further employed sparse partial least squares (sparse-PLS) and meta-analysis to examine the developmental associations of the IVFC with cognition and transdiagnostic dimensions of psychopathology in early, middle, and late adolescence. Our results revealed that the IVFC spatial topography reflects the brain functional integration and structure-function decoupling. Age effects on the IVFC of association networks were mediated by the FC among the triple networks, including frontoparietal, salience, and default mode networks (DMN), while those of primary and cerebellar networks were mediated by the cerebello-cortical FC. The IVFC of the triple and cerebellar networks explained the variance of executive functions and externalizing behaviors in early adolescence and then the variance of emotion and internalizing and psychosis in middle and late adolescence. We further evaluated this finding via meta-analysis on task-based studies on cognition and psychopathology. These findings implicate the emerging importance of the IVFC of the triple and cerebellar networks in cognitive, emotional, and psychopathological development during adolescence.

Association of Attachment and Reflective Function with Baseline Symptoms in Child and Adolescent Psychodynamic Psychotherapy

ABSTRACT The present study aimed to verify the associations between symptoms reported at baseline, attachment style and reflective function (RF) in children and adolescents. For this, we conducted a cross-sectional and naturalistic study, including 90 children and adolescents aged between 9 and 17 years old (M = 13.04, SD = 2.72). Instruments were a demographic form, the Child Behavior Checklist, the Friends and Family Interview and the Reflective Function Questionnaire for Youths. From our findings, internalizing symptoms were reported in 74.4% of the cases, and externalizing symptoms in 55.6%. Concerning the attachment styles, 46.7% of the cases were classified as insecure-dismissing, 38.9% as insecure-preoccupied, 10% as secure and 4.4% as disorganized. Participants’ scores for RF were low. We found associations between attachment styles and anxiety, depression and withdrawal symptoms. We found significant differences between the insecure-dismissing style and the insecure-preoccupied and disorganized styles groups regarding anxiety and depression symptoms. The secure attachment style group showed significant differences in withdrawal symptoms when compared to insecure attachment style groups. Further studies exploring associations between attachment styles, RF and psychopathology in childhood and adolescence, could contribute to the evaluation and planning of psychotherapies processes with this population.

Internet addiction in adolescents: Role of family, personality and comorbid psychopathology in school children in Eastern India.

Context:There is an increasing prevalence of internet addiction among adolescents during the COVID-19 pandemic, but very few Indian studies have assessed and taken into account various factors that can explain internet addiction in this vulnerable population.Aims:We examine the differences in family functioning, temperament, character and psychopathology in adolescents with and without internet addiction.Settings and Design:1000 adolescents from urban middle-class families were included in this cross-sectional, two-randomized-group designed, comparative study. Clinical and control group population were selected from high schools. Those with severe internet addiction were compared to those with no addiction.Methods and Materials:Internet Addiction Test, Temperament and Character Inventory, Devereux Scale of Mental Disorders and McMaster Family Assessment Device were administered along with General Health and CRAFFT Questionnaire as screening tool.Statistical Analysis Used:Mann–Whitney U test was done along with Spearman’s rank-difference coefficient of correlation.Result:Adolescents with internet addiction had high novelty seeking and low persistence. Internet addiction was also associated with conduct problems and depression. There was a significant positive association between depression and years of internet usage. Family of adolescents with internet addiction had increased difficulty in problem solving, communication, affective responsiveness, affective involvement and behavior control.Conclusion:Adolescents with internet addiction have temperament difficulties, more psychopathology and belong to dysfunctional families. Since the family plays a central role in an Indian context, family-focused strategies must also be included in the management of internet addiction.