Exclusion Of Adolescents Research Articles

Recreational awareness prevents digital game addiction associated with social exclusion in adolescents

ABSTRACT Digital game addiction has become an important topic in recent years, and research into this area is constantly expanding because of the vast popularity of video games. These studies examine the physical, psychological, and social origins of digital game addiction to better understand the issues that might result from it. The current study seeks to shed light on the preventative impact of recreational awareness on digital game addiction linked to social exclusion within this context. Data were gathered through an online survey method, and a total of 346 Turkish adolescents (ages 15–18) were included in the sample. The findings revealed that recreational awareness had a negative moderating effect on the relationship between social exclusion and digital game addiction. Moreover, it was determined that men had higher levels of digital game addiction compared to women and women had higher levels of social exclusion compared to men. The results obtained from the research have been discussed in the relevant section, and recommendations have been formulated considering the outcomes.

Emotional reactivity and prosocial behaviour in response to witnessing social exclusion in adolescents with eating disorders and healthy controls

BackgroundProsocial behaviour can promote positive social interactions and it is a key skill in adolescence. People with emotional problems or psychiatric disorders, such as people with eating disorders might have impairments in prosocial behaviour, due to broader documented difficulties in underlying processes (e.g., mentalizing).MethodsThe aim of this study was to examine prosocial behaviour in adolescents with eating disorders compared to healthy controls, using a computerised behavioural task. Adolescents (N = 123) including patients with eating disorders (n = 61) and healthy adolescents (n = 62) played a four-player computerised Prosocial Cyberball Game with three pre-programmed avatar players. During the task, participants witnessed the exclusion of one of the players, and subsequently had the opportunity to compensate for this by throwing the ball more often to the excluded player. Throughout the game, participants rated the level of negative emotion in themselves and in the excluded player.ResultsPatients made significantly fewer ball tosses towards the excluded player during the compensation round compared to healthy controls (large effect size). Patients reported a significantly smaller increase in negative emotion after witnessing the exclusion and a significantly smaller decrease in negative emotion following the compensation round (large effect sizes). Patients also estimated a smaller decrease in negative emotion in the excluded player following the compensation round (medium effect size). There were no significant associations between these outcomes and eating disorder psychopathology in patients.ConclusionsCompared to healthy adolescents, adolescent patients with eating disorders demonstrated less prosocial compensatory behaviour towards a computerised victim of social exclusion. In addition, they reported flatter negative emotion in themselves in response to witnessing and compensating for exclusion, and in the excluded player following compensation. If these findings are replicated, interventions to target these difficulties might contribute to improvements in social functioning in this patient group.

Follicular lymphoma in children and adolescents: clinical, diagnostic and therapeutic features

Ffollicular lymphoma (FL) is one of the most common non-Hodgkin’s lymphomas in adults, while it is a diagnosis of exclusion in adolescents and children. Clinical manifestations of FL in children are represented by long-term asymptomatic lymphadenopathy, less commonly by extranodal areas involvement. treatment standards for FL in children have not been developed and may vary from observational tactics (with the radical resection of a single focus during a biopsy) to the use of radiation therapy and polychemotherapy. Pediatric type follicular lymphoma was first identified as a distinct variant in 2008 in the world Health organization classification of hematopoietic and lymphoid tissue tumors. Clinical, morphological (cytological type 3A), Immunohistochemical (absence of bcl2 expression in the center of the follicle) and cytogenetic (absence of t(14;18)(q32;q21)) features served as the reason for separation into an independent nosological variant. Despite the term “pediatric”, cases of pediatric type FL have been described in adults over 30 years of age. Most often, the disease is diagnosed in the early stages (I, II) and is characterized by a favorable prognosis. In children and adolescents, FL occurs not only of the pediatric type. we present a clinical case of a typical “adult” type FL (grade 1–2) in a 17-year-old patient. the cHop therapy (cyclophosphamide, doxorubicin, vincristine, and prednisolone) with rituximab resulted in a complete remission, which lasted more than 2.5 years.

Diabetes-specific eating disorder and social exclusion in adolescents with type 1 diabetes

Diabetes-specific eating disorder and social exclusion in adolescents with type 1 diabetes

Factors Contributing to the Social Exclusion of Secondary School Aged Youth

The study describes secondary school nurses’, subject teachers’, special needs teachers’, study counsellors’ and school social workers’ (n=60) experiences of factors that contribute to the development of social exclusion in adolescents. The data were collected in Finland using an online survey tool in 2022 and analysed using inductive content analysis. Some factors associated with social exclusion of the adolescents concerned the youth themselves: problems with self-esteem, learning, emotional intelligence, mental health and intoxicants; while other factors concerned families: problems with family dynamics, interaction, mental health and socioeconomic issues. Inadequate support and mental health services were also mentioned by the participants. Mental health problems, especially depression, are relatively common in families and a major risk factor for the development of social exclusion. In addition, some of the other factors, for example problems in family dynamics, could be secondary, reflecting diagnosed or undiagnosed mental health problems. The risk of social exclusion is likely to increase if several of these factors are accumulated in a young person’s life, possibly passed on from the earlier generation and reinforced in the family home.

Use of ICT and social networks in the neurodevelopment of minors

The presence of technologies in all areas and stages of life increases the risk of addiction to devices, networks, and the use of various programmes. Excessive use of devices and technologies during childhood and adolescence has negative effects on neurodevelopment and causes emotional disorders related to anxiety, stress, and depression. These disorders can be associated with the development of other addictions (alcohol, psychoactive substances) or other situations of risk of social exclusion such as bullying, among others. In our study of the risk of social exclusion in adolescents (ÁVALOS, 2022) we have applied a complete diagnostic battery to 25 subjects of both sexes between 12 and 17 years of age focusing on six dimensions of risk: anxiety and depression, alcohol and other substance abuse, bullying, addiction to technologies, gender violence and risk behaviour in love and sexual relationships, and difficult family situation. The aim of this paper is to present and analyse the correlations found between each of the first three dimensions, and the technology addiction dimension as a predictor of other risk factors for social exclusion. The data show that addiction to video games, in particular, is related to high levels of depression, while addiction to any of the technologies studied (mobile, internet and video games) is significantly related to being a victim of bullying.

Differential neural sensitivity to social inclusion and exclusion in adolescents in foster care

ObjectivesAdolescents in foster care may exhibit differential patterns of brain functioning that contribute to their pervasive socioemotional challenges. However, there has been limited investigation of implicated neural processes, particularly in the social domain. Thus, the current study investigated neural responses to exclusionary and inclusionary peer interactions in adolescents in foster-care. MethodsParticipants comprised adolescents aged 11–18 years in foster care (N = 69) and a community sample (N = 69). They completed an fMRI adaptation of Cyberball, a virtual ball-throwing paradigm, that included periods of exclusion and over-inclusion. To investigate neural sensitivity to peer social experiences, we quantified neural responses that scaled with consecutive inclusionary and exclusionary interactions (using parametric modulators). ResultsRelative to the community sample, adolescents in foster care exhibited increasing response to consecutive exclusionary events in lateral prefrontal regions and decreasing response to consecutive inclusionary events in the intraparietal sulcus and temporo-occipital cortex. Further, exploratory analyses revealed that dorsolateral prefrontal activation to exclusion was related to externalizing problems, particularly in the foster care sample. ConclusionsFindings highlight greater neural sensitivity to exclusionary, and lesser sensitivity to inclusionary, peer interactions in adolescents in foster care. Engagement of prefrontal clusters may reflect greater salience and emotion regulatory processes during exclusion, while parietal and temporal clusters may reflect reduced attention and behavioural engagement during inclusion. Thus foster care involvement is associated with broad changes in neural responses during peer interactions, and further these potentially relate to externalizing problems that have been identified in this vulnerable population.

Inclusion of Adolescents in Adult Clinical Trials: Report of the Institute for Advanced Clinical Trials for Children's Pediatric Innovation Research Forum.

Including adolescents in adult clinical trials can play an important role in making innovative new medicines available to children in a timelier fashion. Stakeholders involved in the processes leading to regulatory approval and labeling of new drugs recognize that challenges exist in involving adolescents and older children in clinical trials before the safety and efficacy of these drugs are established for adults. However, it has been possible to design and execute phase 3 trials that combine adults with adolescents which are medically and scientifically sound and ethically justified. Based on this experience and considerations of the medical and scientific, ethical, and operation-related matters, the 2019 Pediatric Innovation Research Forum advocated for the position that adolescents routinely be considered for enrollment in phase 3 clinical trials. The Forum also concluded that exclusion of adolescents in adult pivotal trials occur only when a thorough evaluation of the target disease and the potential benefit and risks of the study intervention supports a delay in their involvement until after completion of clinical trials in adults.

Psychosocial and biological risk factors of anxiety disorders in adolescents: a TRAILS report

Anxiety disorders are a common problem in adolescent mental health. Previous studies have investigated only a limited number of risk factors for the development of anxiety disorders concurrently. By investigating multiple factors simultaneously, a more complete understanding of the etiology of anxiety disorders can be reached. Therefore, we assessed preadolescent socio-demographic, familial, psychosocial, and biological factors and their association with the onset of anxiety disorders in adolescence. This study was conducted among 1584 Dutch participants of the TRacking Adolescents’ Individual Lives Survey (TRAILS). Potential risk factors were assessed at baseline (age 10–12), and included socio-demographic (sex, socioeconomic status), familial (parental anxiety and depression), psychosocial (childhood adversity, temperament), and biological (body mass index, heart rate, blood pressure, cortisol) variables. Anxiety disorders were assessed at about age 19 years through the Composite International Diagnostic Interview (CIDI). Univariate and multivariate logistic regression analyses were performed with onset of anxiety disorder as a dependent variable and the above-mentioned putative risk factors as predictors. Of the total sample, 25.7% had a lifetime diagnosis of anxiety disorder at age 19 years. Anxiety disorders were twice as prevalent in girls as in boys. Multivariate logistic regression analysis showed that being female (OR = 2.38, p < .01), parental depression and anxiety (OR = 1.34, p = .04), temperamental frustration (OR = 1.31, p = .02) and low effortful control (OR = 0.76, p = .01) independently predicted anxiety disorders. We found no associations between biological factors and anxiety disorder. After exclusion of adolescents with an onset of anxiety disorder before age 12 years, being female was the only significant predictor of anxiety disorder. Being female was the strongest predictor for the onset of anxiety disorder. Psychological and parental psychopathology factors increased the risk of diagnosis of anxiety, but to a lesser extent. Biological factors (heart rate, blood pressure, cortisol, and BMI), at least as measured in the present study, are unlikely to be useful tools for anxiety prevention and intervention strategies.

Direct assessment of mental health and metabolic syndrome amongst Indonesian adolescents: a study design for a mixed-methods study sampled from school and community settings

ABSTRACT Non-communicable diseases (NCDs) are the leading cause of morbidity and mortality globally, with the burden largely borne by people living in low- and middle-income countries. Adolescents are central to NCD control through the potential to modify risks and alter the trajectory of these diseases across the life-course. However, an absence of epidemiological data has contributed to the relative exclusion of adolescents from policies and responses. This paper documents the design of a study to measure the burden of metabolic syndrome (a key risk for NCDs) and poor mental health (a key outcome) amongst Indonesian adolescents. Using a mixed-method design, we sampled 16–18-year-old adolescents from schools and community-based settings across Jakarta and South Sulawesi. Initial formative qualitative enquiry used focus group discussions to understand how young people conceptualise mental health and body weight (separately); what they perceive as determinants of these NCDs; and what responses to these NCDs should involve. These findings informed the design of a quantitative survey that adolescents self-completed electronically. Mental health was measured using the Centre for Epidemiologic Studies Depression Scale-Revised (CESD-R) and Kessler-10 (both validated against formal psychiatric interview in a subsample), with the metabolic syndrome measured using biomarkers and anthropometry. The survey also included scales relating to victimisation, connectedness, self-efficacy, body image and quality of life. Adolescents were sampled from schools using a multistage cluster design, and from the community using respondent-driven sampling (RDS). This study will substantially advance the field of NCD measurement amongst adolescents, especially in settings like Indonesia. It demonstrates that high quality, objective measurement is acceptable and feasible, including the collection of biomarkers in a school-based setting. It demonstrates how comparable data can be collected across both in-school and out of school adolescents, allowing a more comprehensive measure of NCD burden, risk and correlates.

Turning a Blind Eye? Punishment of Friends and Unfamiliar Peers After Observed Exclusion in Adolescence.

In order to decrease the occurrence of social exclusion in adolescence, we need to better understand how adolescents perceive and behave toward peers involved in exclusion. We examined the role of friendships in treatment of perpetrators and victims of social exclusion. Eighty‐nine participants (aged 9–16) observed exclusion of an unfamiliar peer (victim) by their best friend and another unfamiliar peer. Subsequently, participants could give up valuable coins to altruistically punish or help peers. Results showed that participants altruistically compensated victims and punished unfamiliar excluders, but refrained from punishing their friends. Our findings show that friendship with excluders modulates altruistic punishment of peers and provide mechanistic insight into how friendships may influence treatment of peers involved in social exclusion during adolescence.

Differential Neural Processing of Social Exclusion and Inclusion in Adolescents with Non-Suicidal Self-Injury and Young Adults with Borderline Personality Disorder.

Non-suicidal self-injury (NSSI) is a symptom of borderline personality disorder (BPD). However, NSSI often occurs independently of BPD. Altered neural processing of social exclusion has been shown in adolescents with NSSI and adults with BPD with additional alterations during social inclusion in BPD patients. Aims of this study were to investigate differences in neural processing of social inclusion and exclusion situations between adolescents with NSSI and young adults with BPD and NSSI. Using fMRI, neural processing of positive and negative social situations (paradigm: "Cyberball") was explored. Participants were 14 adolescents with NSSI, but without BPD (Mage = 15.4; SD = 1.9), 15 adults with BPD and NSSI (Mage = 23.3; SD = 4.1), as well as 15 healthy adolescents (Mage = 14.5; SD = 1.7), and 16 healthy adults (Mage = 23.2; SD = 4.4). Behavioral results showed enhanced feelings of social exclusion in both patient groups as compared to healthy controls but only the NSSI group showed enhanced activation during social exclusion versus inclusion compared to the other groups. While both NSSI and BPD groups showed enhanced activation in the ventral anterior cingulate cortex during social exclusion as compared to their age-matched controls, enhanced activation during social inclusion as compared to a passive watching condition was mainly observed in the BPD group in the dorsolateral and dorsomedial prefrontal cortex, and the anterior insula. While neural processing of social exclusion was pronounced in adolescents with NSSI, BPD patients also showed increased activity in a per se positive social situation. These results might point toward a higher responsiveness to social exclusion in adolescents with NSSI, which might then develop into a generalized increased sensitivity to all kinds of social situations in adults with BPD.

Peer status in relation to psychotic experiences and psychosocial problems in adolescents: a longitudinal school-based study.

Social exclusion is related to many adverse mental health outcomes and may be particularly harmful for mental health in adolescence when peer relations become very important. This study examined associations between low peer status and psychotic experiences, psychosocial problems and short-term courses of these symptoms. A school-based sample of adolescents (N=1171) was investigated in 2 consecutive years using the 16-item Prodromal Questionnaire and the self-report and teacher-report version of the Strengths and Difficulties Questionnaire (SDQ). Peer status was measured in the second year with positive and negative peer nominations of classmates. Low peer status was, after adjusting for gender, ethnic minority status and level of education, associated with more psychosocial difficulties with a persistent course and a higher level of psychotic experiences. Of all peer status groups, being neglected had the strongest associations with mental health problems. The results of this study show that social exclusion in adolescence is related to psychotic experiences and psychosocial problems, emphasizing the importance of belonging to a social group. Customized prevention programs at individual, family and school level should target causes and consequences of social exclusion.

Preliminary evidence for increased parasympathetic activity during social inclusion and exclusion in adolescents with functional abdominal pain

ObjectivePeer victimization (e.g. social exclusion) has been shown to be associated with physical health problems such as functional somatic complaints and especially symptoms of pain. To date, no study has investigated the mechanisms underlying this association in clinical pediatric samples. The aim of this study was to evaluate the parasympathetic activity during a social exclusion experience in adolescents with functional abdominal pain (FAP). MethodsTwenty adolecents with FAP and 21 matched healthy participants were compared regarding parameters of parasympathetic activation before, during, and after participating in the Cyberball-game, a well-established paradigm to induce social exclusion. ResultsAdolescents with FAP showed an increase in parasympathetic activation during both consecutive phases of the Cyberball game (inclusion as well as exclusion condition) whereas the healthy control group remained stable. There were no differences in subjective experience of in- and exclusion between the groups. ConclusionThe parasympathetic activation pattern may indicate altered processing of social stimuli in adolescents with FAP.

Neural responses to social exclusion in adolescents: Effects of peer status

We examined whether adolescents' neural responses to social exclusion and inclusion are influenced by their own popularity and acceptance and by the popularity of their excluders and includers. Accepted adolescents are highly prosocial. In contrast, popular adolescents, who are central and influential, show prosocial as well as antisocial behaviors, such as peer exclusion. Fifty-two 12–16 year-old adolescents underwent an functional magnetic resonance imaging (fMRI) scan while playing the ball-tossing game Cyberball in which they received or did not receive the ball from other virtual players. The other virtual players were described as either highly popular or average in popularity. Participants' own popularity and acceptance were assessed with peer nominations at school (n = 31). Participants' acceptance was positively correlated with activity of the dorsal anterior cingulate cortex (ACC) during exclusion. Participants' popularity was positively associated with ventral striatum and medial prefrontal cortex activity during exclusion, but only when the excluders were popular virtual players. Participants showed increased rostral ACC activation to inclusion by players who were average in popularity. These findings indicate that peer status plays an important role in adolescents' neural processing of social exclusion and inclusion. Moreover, these findings underscore that popularity and acceptance are distinct types of high peer status in adolescence, with not only distinct behavioral correlates, but also distinct neural correlates.

Vinculación entre la vulnerabilidad y la exclusión social y las trayectorias delictivas. Un estudio de asociación

The aim of this study is to identify the relationship between criminal trajectories and factors involving vulnerability and social exclusion in adolescents in conflict with the law. To this end we analysed 281 case files of these adolescents in the city of Valencia and produced 3 types of criminal trajectory —initial, moderate and consolidated— associated with vulnerability and social exclusion indicators. Empirical evidence of the relationship is provided. Criminal trajectories and factors involving vulnerability and social exclusion are found to be closely connected, intertwined and overlapping. The accumulation of vulnerability and social exclusion factors in adolescents in conflict with the law works in such a way that the greater the accumulation and intensity, the greater the probability of developing a consolidated criminal trajectory. Demonstrating the link between them is essential in order to modify psychosocial intervention with these adolescents, whether this happens before the start of the criminal trajectory or later so as to prevent it from becoming consolidated.

Differential neural processing of social exclusion in adolescents with non-suicidal self-injury: An fMRI study

Non-suicidal self-injury (NSSI) is highly prevalent in adolescence and has been suggested as an autonomous diagnosis in the Diagnostic and Statistical Manual (DSM-5). Social rejection is as potential risk-factor for NSSI and depression in adolescence. Objectives of this study were to identify differences in neural processing of social rejection in depressed adolescents with and without co-morbid NSSI and healthy controls. Participants were 28 depressed adolescents (14 with co-morbid NSSI, 79% females) and 15 healthy controls, with an average age of 15.2 years (SD=1.8). Social exclusion was implemented using the Cyberball paradigm ‘Cyberball’ during functional magnetic resonance imaging (fMRI). All participants reported feelings of social exclusion after fMRI scanning. Investigating the effects of NSSI, we found that depressed adolescents with NSSI showed relatively enhanced activation of the medial prefrontal cortex (mPFC) and the ventrolateral prefrontal cortex (vlPFC) compared to depressed adolescents without NSSI and also compared to healthy controls. Results point towards divergent processing of social exclusion in depressed adolescents with NSSI as compared to adolescents with mere depression in brain regions previously related to the processing of social exclusion. This finding of distinct neurophysiological responses may stimulate further research on individual treatment approaches.

Unlike adults, children and adolescents show predominantly increased neural activation to social exclusion by members of the opposite gender

ABSTRACTThe effects of group membership on brain responses to social exclusion have been investigated in adults, revealing greater anterior cingulate responses to exclusion by members of one’s in-group (e.g., same-gender). However, social exclusion is a critical aspect of peer relations in youth and reaches heightened salience during adolescence, a time when social anxiety disorders are also emergent. While the behavioral and neural correlates of social exclusion in adolescence have been extensively explored, the effects of group membership on peer rejection are less clear. The current study used functional magnetic resonance imaging (fMRI) to investigate the differential neural correlates of being excluded by peers of one’s same- versus opposite-gender during an online ball-toss game. Participants were a group of typically developing children and adolescents (7–17 years). As predicted, anterior cingulate cortex showed a main effect of social exclusion versus fair play. However, unlike a previous adult study, this region did not show increased activation to same-gender exclusion. Instead, several regions differentiating same- versus opposite-gender exclusion were exclusively more sensitive to exclusion by one’s opposite gender. These results are discussed in the context of adolescent socio-emotional development.

Chronic Childhood Peer Rejection is Associated with Heightened Neural Responses to Social Exclusion During Adolescence.

This functional Magnetic Resonance Imaging (fMRI) study examined subjective and neural responses to social exclusion in adolescents (age 12–15) who either had a stable accepted (n = 27; 14 males) or a chronic rejected (n = 19; 12 males) status among peers from age 6 to 12. Both groups of adolescents reported similar increases in distress after being excluded in a virtual ball-tossing game (Cyberball), but adolescents with a history of chronic peer rejection showed higher activity in brain regions previously linked to the detection of, and the distress caused by, social exclusion. Specifically, compared with stably accepted adolescents, chronically rejected adolescents displayed: 1) higher activity in the dorsal anterior cingulate cortex (dACC) during social exclusion and 2) higher activity in the dACC and anterior prefrontal cortex when they were incidentally excluded in a social interaction in which they were overall included. These findings demonstrate that chronic childhood peer rejection is associated with heightened neural responses to social exclusion during adolescence, which has implications for understanding the processes through which peer rejection may lead to adverse effects on mental health over time.Electronic supplementary materialThe online version of this article (doi:10.1007/s10802-015-9983-0) contains supplementary material, which is available to authorized users.

Adolescent girls and young women: key populations for HIV epidemic control.

IntroductionAt the epicentre of the HIV epidemic in southern Africa, adolescent girls and young women aged 15–24 contribute a disproportionate ~30% of all new infections and seroconvert 5–7 years earlier than their male peers. This age–sex disparity in HIV acquisition continues to sustain unprecedentedly high incidence rates, and preventing HIV infection in this age group is a pre-requisite for achieving an AIDS-free generation and attaining epidemic control.DiscussionAdolescent girls and young women in southern Africa are uniquely vulnerable to HIV and have up to eight times more infection than their male peers. While the cause of this vulnerability has not been fully elucidated, it is compounded by structural, social and biological factors. These factors include but are not limited to: engagement in age-disparate and/or transactional relationships, few years of schooling, experience of food insecurity, experience of gender-based violence, increased genital inflammation, and amplification of effects of transmission co-factors. Despite the large and immediate HIV prevention need of adolescent girls and young women, there is a dearth of evidence-based interventions to reduce their risk. The exclusion of adolescents in biomedical research is a huge barrier. School and community-based education programmes are commonplace in many settings, yet few have been evaluated and none have demonstrated efficacy in preventing HIV infection. Promising data are emerging on prophylactic use of anti-retrovirals and conditional cash transfers for HIV prevention in these populations.ConclusionsThere is an urgent need to meet the HIV prevention needs of adolescent girls and young women, particularly those who are unable to negotiate monogamy, condom use and/or male circumcision. Concerted efforts to expand the prevention options available to these young women in terms of the development of novel HIV-specific biomedical, structural and behavioural interventions are urgently needed for epidemic control. In the interim, a pragmatic approach of integrating existing HIV prevention efforts into broader sexual reproductive health services is a public health imperative.