Dutch Adolescents Research Articles

Prepandemic Risk Factors of COVID-19-Related Concerns in Adolescents During the COVID-19 Pandemic.

To identify adolescents who may be at risk for adverse outcomes, we examined the extent of COVID‐19‐related concerns reported by adolescents and investigated which prepandemic risk and protective factors predicted these concerns during the COVID‐19 pandemic. Dutch adolescents (N = 188; M age = 13.49, SD = .81) were assessed before the pandemic and at eight and ten months into the pandemic. Results demonstrated that adolescents’ most frequently reported COVID‐19‐related concerns were about social activities and getting delayed in school. Adolescents that have specific vulnerabilities before the pandemic (i.e., higher stress, maladaptive coping, or internalizing problems) experience more concerns during the pandemic, stressing the importance of guiding and supporting these adolescents in order to prevent adverse developmental outcomes.

Friend Support and Internalizing Symptoms in Early Adolescence During COVID-19.

The COVID‐19 pandemic has impacted adolescents’ psychosocial adjustment and social relationships across the world. This prospective longitudinal study examined whether internalizing problems during the pandemic could be predicted by precrisis friend support, and whether this effect was moderated by the time adolescents spent with their friends and COVID‐19‐related stress. 245 Dutch adolescents (M age = 11.60) participated before and during COVID‐19. Higher pre‐COVID‐19 friend support predicted less (self‐reported and parent‐reported) internalizing problems during COVID‐19, and this effect was not moderated by the time adolescents spent with friends or COVID‐19‐related stress. Friends may thus protect against developing internalizing symptoms in times of crisis. We also found the reverse effect: Internalizing problems before COVID‐19 were predictive of friend support during COVID‐19.

Gender-Specific Changes in Life Satisfaction After the COVID-19–Related Lockdown in Dutch Adolescents: A Longitudinal Study

PurposeThe purposes of this study were to assess whether mental well-being has changed after introduction of the lockdown measures compared with that before, whether this change differs between boys and girls, and whether this change is associated with COVID-19–related concerns. MethodsThis is a two-wave prospective study among Dutch adolescents using data collected up to one year before the COVID-19 pandemic (n = 224) and 5–8 weeks after the first introduction of lockdown measures (n = 158). Mental well-being was assessed by three indicators: life satisfaction, internalizing symptoms, and psychosomatic health. General linear model repeated-measures analysis of variance was used to assess whether mental well-being has changed and if this differed by sex. Univariate linear regressions were used to assess associations between COVID-19–related concerns and a change in mental well-being. ResultsLife satisfaction decreased (η2p = .079, p < .001), but no change in internalizing symptoms was observed (η2p = .014, p = .14), and psychosomatic health increased (η2p = .194, p < .001) after the introduction of lockdown measures. Boys scored significantly better on all mental health indicators compared with girls at baseline and follow-up. However, boys' life satisfaction significantly decreased at the follow-up (η2p = .038, p = .015), whereas girls' life satisfaction did not change. Concerns about COVID-19 were significantly associated with a lower life satisfaction and more internalizing symptoms. ConclusionsAdolescents', especially boys', life satisfaction decreased during the lockdown. They reported no change in internalizing symptoms and an improved psychosomatic health. Adolescents' mental well-being is expected to vary during the COVID-19 pandemic and should continue to be monitored.

Bariatric Surgery in Youth: the Perspective of Dutch Pediatricians, Parents, and Adolescents

BackgroundRecent studies have indicated that bariatric surgery is effective for the treatment of youth with severe obesity. The attitudes of pediatricians, parents, and adolescents regarding this topic remain unclear. Therefore, the aim of this study was to assess the current thoughts and beliefs of Dutch pediatricians, parents, and adolescents regarding bariatric surgery in youth.MethodsAn online survey containing twenty questions on bariatric surgery in youth was distributed to pediatricians of the Dutch Society of Pediatrics. Parents and adolescents who participated in an interdisciplinary care program for overweight, obesity, and severe obesity filled out an online survey of twelve questions.ResultsOne hundred and twenty-one pediatricians, 49 parents, and 19 adolescents completed the surveys. Seventy-two pediatricians (59.5%) considered bariatric surgery to be an effective treatment for youth with severe obesity when conventional treatment fails, and intend to refer patients for bariatric surgery. The most frequently suggested conditions for bariatric surgery were a minimum age of 16 years (n = 59, 48.7%), a BMI threshold of 40 kg/m2 (n = 51, 42.2%), and a minimum Tanner stage of IV (n = 59, 48.8%).Thirty parents (61.2%) and fourteen adolescents (73.7%) responded that bariatric surgery should become available for youth with severe obesity.ConclusionDutch pediatricians, parents, and adolescents increasingly accept bariatric surgery as a treatment modality in youth with severe obesity who do not respond successfully to lifestyle intervention. Whether pediatricians will actually refer youth for bariatric surgery remains to be seen when this treatment option will be implemented in the Netherlands.Graphical abstract

Adolescents’ beliefs, attitudes and social norms with regard to smoking and sports: a qualitative study

ObjectivesThe aim of this study is to explore the beliefs, attitudes and social norms of Dutch adolescents with regard to smoking and sports. In addition, we examine whether there are...

Co-Creation Approach with Action-Oriented Research Methods to Strengthen "Krachtvoer"; A School-Based Programme to Enhance Healthy Nutrition in Adolescents.

In recent years, the nutritional pattern of the Dutch adolescent has cautiously improved. However, progress can be gained if more Dutch adolescents adhere to the nutritional guidelines. School-based initiatives offer opportunities to deal with the unhealthy eating behaviours of adolescents via nutrition educational interventions. In designing and/or re-designing school-based interventions, it is important to enhance optimal context-oriented implementation adaptation by involving the complex adaptive school system. This paper elaborates on the way of dealing with the dynamic implementation context of the educational programme “Krachtvoer” (ENG: “Power food”) for prevocational schools, how the programme can be adapted to each unique implementation context, and how the programme can be progressively kept up to date. Following a co-creation-guided approach with various intersectoral stakeholders within and outside the school setting, action-oriented mixed research methods (i.e., observations, semi-structured interviews, focus group interviews, programme usage monitoring, and questionnaires) constantly provide input to develop the programme and its implementation strategy via continuous micro-process cycles. Successful co-creation of school-based health promotion seems to be dependent on proper intersectoral cooperation between research and practice communities, a national partner network that can provide project-relevant insights and establish capacity building aimed at improving contextual fit, and a time-investment balance in and between sectors.

Postdivorce Coparenting Patterns and Relations With Adolescent Adjustment

This study examined the association between postdivorce coparenting patterns and adolescent internalizing and externalizing behavior. Children after parental divorce increasingly grow up in shared residence arrangements, making postdivorce coparenting much more pertinent. The Coparenting Behavior Questionnaire was used to investigate the perceptions of 251 Dutch adolescents regarding postdivorce coparenting behaviors. Latent class analysis was used to identify coparenting patterns, and associations with adolescent outcomes were examined. Four distinct postdivorce coparenting patterns were identified: cooperative, negatively engaged, negatively disengaged, and average. Adolescents of parents with a cooperative pattern reported the least amount of internalizing and externalizing problems, whereas adolescents with negatively engaged parents reported the most internalizing problems. In line with family systems theory, interactions in the coparental subsystem are associated with adolescent adjustment and can therefore be viewed as both a risk and protective factor.

Plurality in the Measurement of Social Media Use and Mental Health: An Exploratory Study Among Adolescents and Young Adults

On a daily basis, individuals between 12 and 25 years of age engage with their mobile devices for many hours. Social Media Use (SMU) has important implications for the social life of younger individuals in particular. However, measuring SMU and its effects often poses challenges to researchers. In this exploratory study, we focus on some of these challenges, by addressing how plurality in the measurement and age-specific characteristics of SMU can influence its relationship with measures of subjective mental health (MH). We conducted a survey among a nationally representative sample of Dutch adolescents and young adults ( N = 3,669). Using these data, we show that measures of SMU show little similarity with each other, and that age-group differences underlie SMU. Similar to the small associations previously shown in social media-effects research, we also find some evidence that greater SMU associates to drops and to increases in MH. Albeit nuanced, associations between SMU and MH were found to be characterized by both linear and quadratic functions. These findings bear implications for the level of association between different measures of SMU and its theorized relationship with other dependent variables of interest in media-effects research.

Validation of the Social Media Disorder Scale in Adolescents: Findings From a Large-Scale Nationally Representative Sample.

Large-scale validation research on instruments measuring problematic social media use (SMU) is scarce. Using a nationally representative sample of 6,626 Dutch adolescents aged 12 to 16 years, the present study examined the psychometric properties of the nine-item Social Media Disorder scale. The structural validity was solid, because one underlying factor was identified, with adequate factor loadings. The internal consistency was good, but the test information was most reliable at moderate to high scores on the scale’s continuum. The factor structure was measurement invariant across different subpopulations. Three subgroups were identified, distinguished by low, medium, and high probabilities of endorsing the criteria. Higher levels of problematic SMU were associated with higher probabilities of mental, school, and sleep problems, confirming adequate criterion validity. Girls, lower educated adolescents, 15-year-olds, and non-Western adolescents were most likely to report problematic SMU. Given its good psychometric properties, the scale is suitable for research on problematic SMU among adolescents.

Lack of Associations Between C-Reactive Protein and Mood and Anxiety Symptoms in Adolescents.

Introduction: Increased peripheral inflammation has been consistently documented in both adult and pediatric depression. However, elevated levels of C-reactive protein (CRP), a nonspecific biomarker for inflammation, have been primarily reported in adults; whether CRP plays a similar role in adolescent depression has not been conclusively established. In our prior work, we identified relationships between CRP and reward neurocircuitry in adolescents with psychiatric symptoms (N = 64) but not with depressive symptoms. Extending this work, we sought to examine CRP across the full range of mood and anxiety symptom severity in a larger, clinically diverse cohort of psychotropic medication-free adolescents and healthy controls (HCs). Methods: Subjects were adolescents (N = 127, age: 15.17 ± 2.19 years, 78 female) with psychiatric symptoms (n = 96, including previous cohort of 64) and HC (n = 31). All completed a semi-structured psychiatric evaluation and dimensional assessments for depression, anxiety, anhedonia, and suicidality. Group-comparison and correlation analyses utilized nonparametric statistics controlled for body mass index, sex, and age at pFWE < 0.05. Results: No group differences were identified in CRP levels between the clinical cohort and HCs. In addition, correlations between CRP and clinical symptomatology were not significant in either the whole sample or the psychiatric group. Conclusions: We found that, unlike in adults, CRP was not associated with depressive symptoms. This suggests that inflammation in pediatric depression is more narrowly delimited at the onset of psychiatric symptoms and may only become systemic with chronicity.

COVID-19 related stigma and health-protective behaviours among adolescents in the Netherlands: An explorative study.

The COVID-19 pandemic has forced many governments to impose social distancing measures upon its citizens, including in the Netherlands. Motivating adolescents to adhere to measures such as social distancing can be challenging, since adolescents are relatively more affected by them, while experiencing virtually no personal health benefit. In addition, the COVID-19 pandemic seems to impact the social environment of adolescents in schools, as some media sources have reported bullying and stigmatisation of students with an Asian appearance. This study aims to explore the experiences of adolescents regarding their Health-Protective Behaviour (HPB), as well as the prevalence and expression of stigma towards ethnic minorities within the context of the first wave of COVID-19 pandemic. We performed a cross-sectional mixed-methods study, including two independent online questionnaires. An adapted version of the “HPB” questionnaire (n = 528) and the “Measure of Disease-Related Stigma (MDRS)” questionnaire (n = 380), were administered to Dutch adolescents of 10–16 years old, attending primary or secondary school. Furthermore, 15 interviews were held with eight male and seven female adolescents. All data collection took place between March 17 and April 20, 2020. Results show that adolescents perceive COVID-19 as a threat to other peoples’ health, rather than their own, and report adherence to public health measures in the interest of older and more vulnerable members of their community. We found no convincing evidence for widespread misinformation or stigmatising of certain ethnic groups among adolescents related to COVID-19 during this study. Participants acknowledged such behaviour happened in the early stages of the pandemic, before this study was initiated. Adolescents are a vital group for public health researchers to engage with during a pandemic, even when reaching them can be challenging.

Time trends in schoolwork pressure among Dutch adolescents, 2001-2017: Gender and educational differences.

This study investigated gender and educational differences in trends in schoolwork pressure between 2001 and 2017 in nationally representative samples of Dutch adolescents in secondary education. Data from five surveys of the Dutch Health Behaviour in School-aged Children study were used. Across the surveys, an increase in perceived schoolwork pressure was observed. Girls and adolescents enrolled in the higher educational levels reported higher levels of perceived schoolwork pressure and the strongest increase in schoolwork pressure over time. Especially for girls, there was a stronger increase in schoolwork pressure for those enrolled in higher educational tracks. Increases in schoolwork pressure over time were stronger among Dutch girls and students in the higher educational levels. Over time, schoolwork pressure increased most among girls in the highest educational levels. Explanations and implications for these results are discussed.

Mood and emotional reactivity of adolescents during the COVID-19 pandemic: short-term and long-term effects and the impact of social and socioeconomic stressors

Adolescence is a formative period for socio-emotional development which is threatened by the COVID-19 pandemic. The current longitudinal study examined two aims: (1) the short- and long-term effects of the pandemic on young people’s mood (i.e. vigor, tension, and depression levels) and emotional reactivity (i.e. fluctuations in daily mood), and (2) the impact of stressors on mood, emotional reactivity, self-oriented (i.e. maladaptive behavior towards COVID-19 rules) and other-benefitting behaviors (i.e. behavior aimed at helping and comforting others). We conducted an online two-week daily diary study among 462 Dutch adolescents (Mage = 15.27 years, 64% females) and 371 young adults (Mage = 21.49 years, 81% females) in May 2020, with a follow-up in November 2020 (N = 238 and 231, respectively adolescents and young adults). In May 2020, young adults and older relative to younger adolescents showed higher levels and more fluctuations in tension and depression and lower levels of vigor. Vigor levels decreased and tension and depression levels increased between May 2020 and November 2020, especially for younger adolescents. There were positive associations between instability of negative emotions (i.e. tension and depression fluctuations) and the exposure to stressors (i.e. family stress and inequality of online homeschooling) in the adolescent sample. Together, this study demonstrates vulnerability regarding young people’s mood and emotional reactivity during the COVID-19 pandemic, especially for adolescents who experience more stressors.

Communication and COVID-19 Physical Distancing Behavior Among Dutch Youth

<strong>Background:</strong> Although most young people do not become seriously ill from the coronavirus causing the COVID-19 disease, they do play a role in its spread. It is therefore important that they adhere to the recommended preventive behaviors, most importantly, physical distancing. This study aims to gain a better understanding of the psychosocial determinants of young people’s physical distancing behavior and the role that direct (i.e., interpersonal) and mediated communication (i.e., mass media, social media) about COVID-19 plays in this. <strong>Methods:</strong> A daily diary study was conducted among 481 Dutch adolescents (secondary school students; age range 10–18 years) and 404 young adults (university students; age range 17–25 years), involving 10 identical daily surveys administered on weekdays during a 2-week period during the first wave of the COVID-19 pandemic (May 2020). The hypotheses were tested with preregistered univariate and multivariate linear mixed-effects models. <strong>Results:</strong> The perceived descriptive norm (i.e., what friends are doing) was the most important determinant of physical distancing behavior among both adolescents and young adults. The perceived injunctive norm, perceived response efficacy, and perceived severity were also positively associated with physical distancing, albeit less strong. Among adolescents, exposure to information about COVID-19 in the mass media increased their perceptions of the descriptive norm, which in turn increased their physical distancing behavior. <strong>Conclusions:</strong> For those involved in studying and designing COVID-19-related behavioral interventions and campaigns targeting youth, it is important to consider the social norms that they relate to, and to take into account their perceived severity and response efficacy.

Contextual correlates of loneliness in adolescents

PurposeLoneliness is a common problem that can affect an individual’s physical and mental wellbeing. While loneliness has been extensively researched among older people, relatively few studies have investigated loneliness in the adolescent population. In this study, we aim to explore the association between loneliness and contextual factors in a large sample of young people. Data and MethodsData stem from the “National Youth Health Monitor” of the Dutch region of South Limburg. Respondents were 7956 Dutch adolescents aged between 12 and 18. Multivariate logistic analyses were performed to assess the strength of association between loneliness and factors in the domains of family, school, and social media. ResultsIn the current study, 19.4% of adolescents reported being lonely. Parental divorce, having an ill family member, being bullied at school, poor student-teacher relationship, and problematic use of social media were factors significantly associated with loneliness. Practice implicationFamily- and school-based awareness programs may help protect students from developing problematic levels of loneliness..

The role of tobacco smoking and illicit drug use in adolescent acute alcohol intoxication

BackgroundThis study aims to determine the prevalence of tobacco smoking and illicit drug use among Dutch adolescents admitted to hospital for acute alcohol intoxication treatment. Furthermore, socio-demographic predictors for smoking and illicit drug use in the sample population will be studied. The relationship between illicit drug use and specific characteristics of intoxication, such as blood alcohol concentration (BAC) and duration of reduced consciousness is also investigated.MethodsThe national Dutch Paediatric Surveillance Unit was used to prospectively register cases of acute alcohol intoxication from 2007 through 2017. Cases were included if they met the following inclusion criteria: BAC > 0.0 g/L, aged between 10 to 18 years old and requiring hospital treatment due to reduced consciousness. Questionnaires were sent to paediatricians to obtain clinical information.ResultsDuring the period 2007–2017, 5322 cases that met the inclusion criteria were reported. In this patient group, the prevalence of tobacco smoking was 22.2% (CI 21.0–23.5%), while the prevalence of illicit drug use was 11.8% (CI 10.9–12.7%). The predictors for smoking were the absence of alcohol-specific parental rule-setting, lower educational level, non-traditional family structure and positive drug screening. The predictors for illicit drug use were the absence of alcohol-specific parental rule-setting and smoking. Illicit drug use was also associated with a lower BAC at the time of admission.ConclusionsAssessing smoking and illicit drug use among adolescents admitted for acute alcohol intoxication is important in acute cases of intoxication, for outpatient follow-up and for the purposes of prevention. The relationship between simultaneous illicit drug use and a lower BAC is of relevance for paediatricians’ attempts to diagnose acute intoxication. With respect to outpatient follow-up and preventive measures, it is important to be aware that adolescents’ alcohol consumption, tobacco and illicit drug use are related and, ultimately, increase the odds of using other substances.

Prevalence and Correlates of Sext-Sharing Among a Representative Sample of Youth in the Netherlands.

Many adolescents use their electronic devices to send each other sexually explicit texts, photos, and videos of themselves—commonly known as sexting. This can be fun and is not usually problematic. However, if the intended recipient decides to share these sexts with a broader audience, the consequences for the depicted can be detrimental. The purpose of this study was to investigate the prevalence of (non-consensual) sext-sharing among Dutch adolescents and explore the characteristics of those who do, to gain a better understanding of factors involved in dissemination. We used data from “Sex under the age of 25,” a representative national survey on sexual health among a sample of 20,834 Dutch 12–24-year-olds. The prevalence of sext-sharing was estimated using Complex Samples. Logistic regressions were used to assess associations between demographics, school-based sexting education, sexual- and online behavior, and mental health and sext-sharing. About 4% of the adolescents reported having shared someone else's sext in the last six months. Being male, aged 12–14 years, frequent social media usage, watching online porn, sexual experience, and being subjected to sext-sharing themselves associated most strongly with sext-sharing. Our findings show that the likelihood of sext-sharing is lower in older adolescents and that it associates with the extent of adolescents' sexual curiosity and online activity. The overlap between sharing sexts of others and having one's own sext shared suggests that dissemination of personal sexual content might be normalized or used as an act of retribution. Further research could be helpful to explain the mechanisms underlying this overlap. The results of this study illustrate the importance of exposing adolescents to evidence based preventive educational interventions on sexting from 12 years onwards and not just within the context of traditional school-based sex education, but also as a part of the (online) media-literacy curriculum.

Investigating Whether Depressed Youth Exhibiting Elevated Inflammation Perform Worse on Measures of Executive Functioning, Verbal Fluency and Episodic Memory in a Large, Population Based Sample of Dutch Adolescents

Cognitive functioning is disrupted during a depressive episode and cognitive dysfunction persists when depression is in remission. Depressed individuals who exhibit elevated basal levels of inflammation may be at particular risk for cognitive dysfunction.

Maternal stress and depressive symptoms and adolescents\u2019 body mass index: a prospective study

BackgroundGrowing evidence suggests that maternal mental health issues are associated with (young) children’s weight outcomes. However, most studies have been limited by cross-sectional designs and have been aimed at (younger) children. The current prospective study focuses on the link between maternal mental health (i.e., psychological stress and depressive symptoms) and adolescents’ zBMI development.MethodsThe participants in the present study were part of wave 1 and 2 of a longitudinal study on Dutch adolescents’ and their parents’ health behavior. Adolescents (aged 10–14) and their parents were recruited through six secondary schools in the South and the East of the Netherlands. For this study, we only included biological mothers and their adolescent children who participated in both waves, with data on the main measures in both waves, leaving a final sample of 336 biological mother-child dyads. Adolescents height and weight were measured, and both parents and adolescents filled in validated questionnaires on perceived stress and depressive symptoms and answered additional questions concerning domain-specific stress. Regression analyses were performed in R to examine longitudinal links between maternal stress and depressive symptoms at baseline (T1) and adolescents’ BMI standard deviation scores (zBMI) 6 months later (T2), corrected for baseline zBMI and covariates.ResultsMaternal general perceived stress (β = .20, p = .002) at T1 preceded higher adolescents’ zBMI at T2, after controlling for baseline zBMI and other covariates, whereas maternal depressive symptoms at T1 (β = −.05, p = .44) and other domain-specific stress did not (maternal financial stress, maternal stress at work, maternal stress at home). Additionally, lower educational level among adolescents (β = .16, p = .001) and adolescent depressive symptoms (β = .16, p = .001) was associated with a higher zBMI at T2.ConclusionsResults suggest that maternal general stress, but not depressive symptoms, may influence adolescents’ weight development. Our findings warrant future investigation on whether and how general stress among mothers may predict weight increases of their adolescent offspring.

Optimism and Mental Health in Adolescence: a Prospective Validation Study of the Dutch Life-Orientation Test-Revised (LOT-R-A) for Adolescents.

The study aimed to examine the psychometric properties of the Dutch Life Orientation Test-Revised for Adolescents (LOT-R-A), a self-report questionnaire assessing dispositional optimism, and to evaluate the two-factor structure (optimism, pessimism). The LOT-R-A and the questionnaires measuring well-being (MHC-SF-A) and psychological problems (SDQ) were completed by 459 Dutch adolescents (178 boys and 281 girls) between the ages of 11 and 18 years at baseline and 281 adolescents at a four-week follow-up. The results confirmed the two-factor structure (optimism, pessimism) of the LOT-R-A. The findings provided evidence of internal consistency of scores ranging from low to good, and evidence of good test-retest reliability of scores. Further, scores of optimism were cross-sectionally positively associated with scores of positive emotions and well-being and negatively with scores of psychological problems and negative emotions, providing evidence of convergent and divergent validity of optimism scores with emotions, well-being, and psychological problems. Lastly, scores of optimism were prospectively positively associated with scores of well-being and negatively with scores of psychological problems, providing evidence of criterion validity of optimism scores with well-being and psychological problems. Based on these findings it can be concluded that the LOT-R-A is a valid instrument to examine optimism among adolescents. Future research can help to elucidate the role of optimism in mental health interventions and can gather knowledge on how these interventions can be refined to optimally cultivate optimism during the developmental period of adolescence.