Adolescent Health Research Articles

Smoking cessation influencing factors and interventions in adolescents

Smoking can negatively influence the development of the respiratory and cardiovascular systems of adolescents and increase the risk for chronic diseases in adulthood. Promotion smoking cessation in adolescents is important for the protection of adolescent health and reduction of smoking rate in adults. Although many foreign studies have explored the influencing factors and interventions for smoking cessation in adolescents, limited relevant studies have been conducted in China, especially the study of smoking cessation intervention, which is still in its infancy, so the research and practice in this field need to be strengthened. This paper summarizes the factors associated with smoking cessation in adolescents both at home and abroad from the perspective of individual, family, school, and social surrounding, and introduce existing smoking cessation interventions for adolescents to provide references for future studies.

Developmental relations between depression and suicidal ideation among adolescents: A latent change score modeling study

Currently, there is a high incidence of depression and suicidal ideation among adolescents which has serious adverse effects on the adolescent's physical and mental health. This study evaluated developmental relations between depression and suicidal ideation among Chinese adolescents. We conducted a three-wave longitudinal study with 1214 participants over one year. Latent change score analysis was employed to examine the univariate and bivariate changes of depression and suicidal ideation. Univariate models indicated a slow increase in both depression and suicidal ideation over time. Bivariate models indicated previous levels of suicidal ideation were positively linked to the subsequent depression growth, but the reverse relation was not found. Our findings contribute to the literature by suggesting a change pattern of suicidal ideation and depression among Chinese adolescents.

Adolescent Lifestyle Behaviour Modification and Mental Health: Longitudinal Changes in Diet, Physical Activity, Sleep, Screen Time, Smoking, and Alcohol Use and Associations with Psychological Distress

AbstractThis study examines longitudinal behaviour change in six key lifestyle behaviours—sleep, physical activity (PA), sedentary recreational screen time, diet, alcohol use, and tobacco use—and associations with mental health in a large study of Australian adolescents. Change between baseline (Mage = 12.7, N = 6,639) and 3-year follow up (Mage = 15.7, N = 4445) was investigated. Generalised linear mixed effects regressions modelled associations between behaviour change and later psychological distress score adjusting for baseline behaviours, baseline psychological distress, social determinants, and school clustering. Changes over time in each of the behaviours were significantly associated with later psychological distress, whereby health-promoting behaviours were associated with reduced psychological distress and vice versa. When all behaviour changes were modelled together, significant effects remained for sleep, PA, vegetable consumption, junk food and SSB consumption, alcohol, and tobacco use. Results highlight the potential benefits of behaviour modification to reduce the progression of psychological distress in adolescence.

“If you’re struggling, you don’t really care” – what affects the physical health of young people on child and adolescent mental health inpatient units? A qualitative study with service users and staff

BackgroundPhysical health inequalities of people with serious mental illness (SMI) have been labelled an international scandal; due to the 15–20-year reduction in life expectancy associated with poor physical health. This occurs at an early stage and evidence shows young people with and at risk for SMI are a particularly vulnerable group requiring intervention and support. However, most work has been conducted with adults and little is known about what affects physical health for young people, specifically those receiving inpatient care.MethodsWe conducted semi-structured qualitative interviews with 7 service users and 6 staff members (85% female, age 14–42) on a generic mental health inpatient unit for children and adolescents. Interviews aimed to identify how young people viewed theirphysical health and factors affecting physical health and lifestyle and identify any support needed to improve physical health. Thematic analysis was conducted. .ResultsThematic analysis revealed the main factors affecting physical health and lifestyle for young people. Three main themes were individual factors (subthemes were mental health symptoms, knowledge, attitudes and beliefs), environmental factors (subthemes were opportunities in a restricted environment and food provision), and the influence of others (subthemes were peers, staff, family members). These factors often overlapped and could promote a healthy lifestyle or combine to increase the risk of poor physical health. Young people discussed their preferences for physical health initiatives and what would help them to live a healthier lifestyle.ConclusionsPromoting physical health on inpatient units for young people is an important, yet neglected area of mental health research. We have identified a range of complex factors which have an impact on their physical health, and there is a pervasive need to address the barriers that young people experience to living a healthy lifestyle. There is an increasingly strong evidence base suggesting the benefits of physical health interventions to improve outcomes, and future work should identify ways to implement such interventions considering the barriers discussed in this article. Further collaborative research is needed with young people, clinical teams, caregivers, and commissioners to ensure improvements are made to clinical care provision and optimisation of the inpatient environment.

Mental Health Aftercare Availability for Juvenile Justice-Involved Youth in New York City.

The goal of our study was to describe the availability of community child and adolescent mental health services, trauma-informed care, and the geographic accessibility of these services for juvenile justice-involved (JJ) youth who received mental health services while in secure detention. Data collection occurred through direct contact with the child and adolescent outpatient clinics listed on the New York State Office of Mental Health website. Zip codes were collected from the juvenile secure detention census. Of the clinics contacted, 88.5 percent accepted JJ youth; however, 43.5 percent accepted them on a conditional basis. Only 62.1 percent offered trauma-informed care, including evidence-based interventions and unspecified care. Although 84.5 percent of the clinics that would accept this population reported currently accepting new patients, reported wait times were as high as six or more months. When JJ residents' home zip codes and those of the clinics were geographically mapped, there were few clinics in the zip codes where most residents lived. The clinics that accepted youth on a conditional basis often refused high-risk patients, essentially ruling out a large majority of this population. The geographical inaccessibility of these clinics limits their ability to provide care for this vulnerable population.

Identifying the challenges of policy content related to high-risk sexual behaviors, stimulant drugs, and alcohol consumption in adolescents

BackgroundThis study aims to identify policy content challenges related to high-risk sexual behaviors, stimulant drugs, and alcohol consumption in Iranian adolescents.MethodsThis qualitative study analyzed high-level and national documents pertaining to adolescent health, high-risk sexual behaviors, stimulant, and alcohol consumption in adolescents. The documents, which were published by public organizations between January 1979 and February 2023 and publicly available, were complemented by interviews with policymakers and executives. The study involved reviewing 51 papers and conducting interviews with 49 policymakers and executives at the national, provincial, and local levels who were involved in addressing adolescent behaviors related to high-risk sexual behaviors, stimulant, and alcohol consumption. The data collected was analyzed using conventional content analysis.ResultsThe study’s results involved examining policy content and identifying challenges related to policy content. The analysis revealed that from the beginning of the Iranian revolution in 1979 until the late 1990s, the dominant approach in Iran was to deny the existence of high-risk behaviors among adolescents. However, in the early 2000s, the country began to adopt a new approach that acknowledged the social harms and ineffectiveness of previous strategies. As a result, a new policy framework was introduced to address high-risk behaviors among adolescents. The study’s interviews with policymakers and executives identified 12 challenges related to policy content, including parallel programs, lack of institutional mapping, lack of evidence-based policymaking, lack of integrated approach regarding training, late parent training, lack of consideration of all occurrence reasons in adolescents’ high-risk behaviors policymaking, and the existence of many abstinence policies regarding high-risk behaviors.ConclusionsThe study’s findings suggest that high-risk behaviors among adolescents in Iran are primarily a health issue, rather than a social or ideological one. Unfortunately, ideological approaches, stigma, and policymaking based on anecdotes rather than evidence have had a significant impact on this area. To improve policymaking in this domain, it is crucial to address these challenges by tackling stigma, adopting an integrated and holistic approach, and implementing evidence-based policies that consider all relevant aspects, including adolescents’ subcultures and policy audiences. Such an approach can also be useful for other countries facing similar conditions.

Parental Neglect and Childhood Obesity Amidst COVID-19: A Developmental Psychopathology Perspective on Health and Developmental Risks.

The COVID-19 pandemic has profoundly impacted the mental health and developmental trajectories of children and adolescents, catalyzing a range of psychological and behavioral issues due to enforced lockdowns and other restrictions. This text explores these impacts through the lens of developmental psychopathology, which integrates clinical psychology and developmental science to examine the emergence and evolution of psychological disorders across a lifespan. This paper highlights how pandemic-related disruptions have exacerbated conditions such as anxiety and depression and, notably, increased childhood obesity due to changes in lifestyle and reductions in physical activity. The analysis includes a discussion of how isolation has not only restricted access to educational and psychological resources but also increased the risk of parental mental illness and related familial stress, thereby intensifying issues of neglect and their consequent impact on child health. By employing a developmental psychopathology framework, this paper argues for the necessity of targeted interventions that address these complex interplays of genetic, environmental, and psychological factors. Such interventions aim to support children through structured educational and health-oriented strategies, ensuring their well-being amidst the ongoing challenges posed by the pandemic. This approach underscores the importance of early, multifaceted strategies involving parents, educators, and healthcare providers to foster healthier developmental outcomes for children facing unprecedented global health crises.

Research progress on the association between screen content and mental health issue in children and adolescents

With the wide use of screen media, screen exposure shows a trend of younger age, and the screen exposure of children and adolescents has become a global public health issue of concern. Childhood and adolescence are important stages of growth and development, as well as critical periods of cognitive ability, emotional development and socialization. Previous studies have shown that screen time is closely related to the mental health of children and adolescents, but few studies have focused on the correlation between screen content and their mental health. The screen content for children and adolescents mainly comes from traditional TV and emerging interactive electronic media. Children and adolescents are highly sensitive to screen content. This paper summarizes the current situation of screen content for children and adolescents and reviews the correlation between screen content and their mental health issues. It also reveals the potential mechanism of the correlation between the two to provide a theoretical basis for the selection and supervision of screen content for children and adolescents.

The experience of autism from the perspective of autistic adolescents

The aim of this study is to explore with autistic adolescents, their perspectives and experiences related to autism. Situated in Australia, the study uses a qualitative methodology and a narrative approach. The findings illustrate a rich and nuanced understanding of autism for adolescents. Autistic adolescents place greater emphasis on difference and diversity rather than difficulty and highlight the positives and strengths of autism characteristics. The findings encourage the framing and conceptualisation of autism in relation to adolescents’ strengths and abilities whilst acknowledging experiences of anger, stress, and anxiety. Most adolescents describe feeling disconnected, emotionally and physically from others. The findings of this study indicate a need for increased awareness and practice of a strengths use in autism. This is to enhance understandings of autism, improve upon the wellbeing and mental health of autistic adolescents and to promote greater connectedness and belonging for this group amongst family, peers, and wider society.

Global burden of skin and subcutaneous diseases and its association with socioeconomic status in children and adolescents: an analysis of the Global Burden of Diseases Study 2019.

Skin and subcutaneous diseases are one of the most common problems affecting the health of children and adolescents. The purpose of this study was to investigate the burden of skin and subcutaneous diseases among children and adolescents and its association with socioeconomic status. Data was obtained from the Global Burden of Disease Study 2019. The number of cases, incidence rate, number of deaths, and death rate in 204 countries and territories from 1990 to 2019 were extracted and stratified by age, sex, and socioeconomic status. In 2019, the global incidence and death rates of skin and subcutaneous diseases in children and adolescents were 57966.98 (95% Uncertainty Interval [UI] 53776.15 to 62521.24) per 100,000 and 0.21 (95% UI 0.13 to 0.26) per 100,000, respectively. From 1990 to 2019, the global incidence rate increased by 5.80% (95% UI 4.82-6.72%) and the death rate decreased by 43.68% (95% UI 23.04-65.27%). The incidence and death rates were negatively correlated with socioeconomic status. Incidence rates were not different between females and males, but death rates were higher among females than males. The highest incidence and death rates were found in the 1-4-year age group and < 1-year age group, respectively. The global burden of skin and subcutaneous diseases in children and adolescents was characterized by regional imbalances. The global burden of skin and subcutaneous diseases in children and adolescents from poorer regions requires more attention. This study provides strong evidence for global policymaking for childhood and adolescent diseases.

Connected communities: Perceived neighborhood social cohesion during adolescence and subsequent health and well-being in young adulthood-An outcome-wide longitudinal approach.

Does higher perceived neighborhood social cohesion in adolescence lead to better health and well-being 10-12 years later? We evaluated this question using data from a large, prospective, and nationally representative sample of USadolescents (Add Health; N = 10,963), and an outcome-wide approach. Across 38 outcomes, perceived neighborhood social cohesion was associated with some: mental health outcomes (i.e., depressive symptoms, suicidal ideation, perceived stress), psychological well-being outcomes (i.e., happiness, optimism), social outcomes (i.e., loneliness, romantic relationship quality, satisfaction with parenting), and civic/prosocial outcomes (i.e., volunteering). However, it was not associated with health behaviors nor physical health outcomes. These results were maintained after robust control for a wide range of potential confounders.

Experience of Service Questionnaire (ESQ) in children and adolescents: factor structure, reliability, validity, item parameters and interpretability of the parent version for practical use in Greece.

Health systems need tools to assess patient's experience of service, but existing tools lack reliability and validity assessment. Our aim is to investigate the factor structure, reliability, validity, item parameters and interpretability of the parent version of the Experience of Service Questionnaire (ESQ) for practical use in Greece. A total of 265 caregivers that were using mental health services in Greece participated in this study as part of the Nationwide cross-sectional survey from the Child and Adolescent Mental Health Initiative (CAMHI). Confirmatory Factor Analysis was used to test factor structure. Reliability of all models were measured with omega coefficients. Tobit regression analysis was used to test for convergent and discriminant validity with specifically designed questions. Item parameters were assessed via Item Response Theory. Interpretability was assessed by means of IRT-based scores. We found that ESQ is best represented and scored as a unidimensional construct, given potential subscales would not have enough reliability apart from a general factor. Convergent and discriminant validity was demonstrated, as caregivers who perceived that their child benefited from the received mental health care had 6.50 higher summed scores (SMD=1.14, p<0.001); while those who believed that their child needed additional help had 5.08 lower summed scores on the ESQ (SMD=-0.89, p<0.001). Average z-scores provided five meaningful categories of services, in terms of user satisfaction, compared to the national average. Our study presents evidence for the reliability and validity of the ESQ and provides recommendations for its practical use in Greece. ESQ can be used to measure experience of service and might help drive improvements in service delivery in the Greek mental health sector.

The role of nurses in implementation of public policy on adolescent health in Colombia, Ecuador, and Peru

BackgroundIn Latin America, interventions aimed at adolescents’ health suffer from a shortfall of investment and lack of sustainability. Nurses, as an integral part of health services and systems, can lead the implementation and development of public health policies to improve adolescent health.ObjectiveTo identify and analyze the role of nurses in the development and implementation of public policies and in the provision of health care to adolescents in Colombia, Ecuador, and Peru.MethodsThe research was carried out in three phases: a documentary analysis, an online survey, and semi-structured focus groups. A total of 48 documents were analyzed, 288 nurses participated in the survey, and 29 nurses participated in the focus groups.ResultsState policies aim to guarantee rights, with special protection for children and adolescents. It is an incremental process, with greater involvement of civil society and governments. Participants reported a lack of synergy between law and practice, as well as differences in regulatory compliance in rural areas and in populations of different ethnicities and cultures. Their perception was that the protection of adolescents is not specifically enshrined in the legal bases and regulatory structures of the countries, meaning that there are both protective factors and tensions in the regulatory framework. While nurses are highly committed to different actions aimed at adolescents, their participation in policy development and implementation is low, with barriers related to a lack of specialized training and working conditions.ConclusionsGiven nurses’ involvement in different actions aimed at adolescents, they could play a fundamental role in the development of policies for adolescents and ensure their effective implementation. Policymakers should consider revising the budget to make compliance viable, incorporating and using monitoring indicators, and increasing the involvement of educational institutions and the community.

Exposure to polyhexamethyleneguanidine phosphate in early life dampens pulmonary damage compared to adult mice

Polyhexamethyleneguanidine phosphate (PHMG-P) is a biocide of guanidine family that can cause a fatal lung damage if exposed directly to the lungs. No reports exist regarding the toxicity of PHMG-P in neonatal animals. Therefore, this study aimed to determine PHMG-P toxicity in neonatal and 8-week-old mice after they were intranasally instilled with 1.5 mg/kg, 3 mg/kg, and 4.5 mg/kg PHMG-P. PHMG-P lung exposure resulted in more severe pulmonary toxicity in adult mice than in newborn mice. In the high-dose group of newborn mice, a minimal degree of inflammatory cell infiltration and fibrosis in the lung were detected, whereas more severe pathological lesions including granulomatous inflammation, fibrosis, and degeneration of the bronchiolar epithelium were observed in adult mice. At day 4, C–C motif chemokine ligand 2 (CCL2), a potent chemokine for monocytes, was upregulated but recovered to normal levels at day 15 in newborn mice. However, increased CCL2 and IL-6 levels were sustained at day 15 in adult mice. When comparing the differentially expressed genes of newborn and adult mice through RNA-seq analysis, there were expression changes in several genes associated with inflammation in neonates that were similar or different from those in adults. Although no significant lung damage occurred in newborns, growth inhibition was observed which was not reversed until the end of the experiment. Further research is needed to determine how growth inhibition from neonatal exposure to PHMG-P affects adolescent and young adult health.

Associations of 24-hour movement behaviors with emotional and behavioral problems among Chinese adolescents.

The role of adherence to the recommendations for 24-hour movement behaviors (24-HMB), including physical activity (PA), screen time (ST), and sleep duration (SLP), in relation to emotional and behavioral problems in Chinese adolescents remains uncertain. This study aimed to investigate these associations and explore potential sex differences. This school-based cross-sectional study included 15,071 Chinese adolescents with a mean age of 14.53 (SD: 1.65) years. Data on emotional and behavioral problems and 24-HMB (including PA, ST, and SLP) were collected. Analysis was performed using general linear mixed models, with additional sex-stratified analyses conducted. The number of 24-HMB recommendations met was negatively associated with total difficulties (β estimate=-0.96, 95% CI: -1.07 to -0.85) and positively related to prosocial behavior (β estimate = 0.41, 95% CI: 0.37 to 0.46) among adolescents. Compared with none of the recommendations met, meeting all recommendations (total difficulties: β estimate=-2.98, 95% CI: -3.41 to -2.55; prosocial behaviors: β estimate = 1.05, 95%CI: 0.87 to 1.24) demonstrated the strongest association with both difficulties and prosocial behaviors, followed by meeting recommendations for PA + ST (total difficulties: β estimate=-2.15, 95% CI: -2.41 to -1.90; prosocial behaviors: β estimate = 0.98, 95% CI: 0.87 to 1.09). These associations were consistently significant in both boys and girls. Adherence to more 24-HMB recommendations, particularly meeting all recommendations or combined PA + ST recommendations, could improve emotional and behavioral well-being among adolescent girls and boys. The significance of balanced movement behaviors for promoting adolescent mental health merits increased attention.

Optimizing adolescent health: Investigating physical activity’s impact on fitness, working memory, and academic performance

This quasi-experimental study investigates the intricate relationship among adolescents’ physical activity, working memory, and academic performance, recognizing their significance in adolescent development. Employing a quasi-experimental design, 85 13-year-olds from a Taiwanese junior high school were involved. Data scrutiny was facilitated through Analysis of Covariance (ANCOVA), with the mediation effect explored via Smart Partial Least Squares structural equation modeling (Smart PLS-SEM). Findings indicate significant improvements in physical fitness among both aerobic and resistance exercise groups compared to controls. Additionally, both exercise cohorts demonstrated a stronger positive association with verbal working memory scores than the control group. Intriguingly, visuospatial working memory fully mediated the relationship between resistance exercise and science performance. These results highlight the potential advantages of incorporating brief daily exercise sessions to bolster adolescent physical fitness and emphasize the mediating function of working memory in connecting physical activity with academic accomplishment. This study furnishes valuable insights for educators and policymakers striving to enhance adolescent well-being and academic achievement through targeted interventions.

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

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

Experiences and Cognitive Characteristics of Non-Suicidal Self-Injury in Adolescents With Depression: A Qualitative Study.

To elucidate the underlying motivations, experiential dimensions, and cognitive perceptions in adolescents with depression and non-suicidal self-injury (NSSI). A descriptive qualitative design was used. Participants were 18 Chinese adolescents with depression and NSSI. Conventional content analysis was used for data analysis. Three primary themes and 11 subthemes were identified: Triggers of NSSI (personal, family, school, and social factors); Experiencing Emotional Complexity in NSSI Implementation (mitigating psychological distress, awakening a sense of existential life, generating secondary negative emotions, stimulating reflections on life and death); and Perceptions and Understandings of NSSI are Diverse (NSSI as a form of seeking validation or approval, an addictive behavior, a means to attain a sense of control, and unacceptable behavior). Although nursing staff should provide comprehensive treatment and psychological support, efforts should also be made to strengthen caregiving skills of family members, thereby promoting overall physical and mental health of adolescents. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

State-level structural racism and adolescent mental health in the United States.

We explored state-level indicators of structural racism on internalizing symptoms of depressive affect among US adolescents. We merged 16 indicators of state-level structural racism with 2015-19 Monitoring the Future surveys (N=41,258) examining associations with loneliness, self-esteem, self-derogation, and depressive symptoms using regression analyses. Students racialized as Black in states with bans on food stamp eligibility and temporary assistance for drug felony conviction had 1.37 times the odds of high depressive symptoms (95% C.I. 1.01-1.89) compared to students in states without bans. In contrast, students racialized as White living in states with more severe disenfranchisement of people convicted of felonies had lower odds of high self-derogation (OR=0.89, 95% C.I. 0.78-1.02) and high depressive symptoms (OR=0.83, 95% C.I. 0.70-0.99) compared to states with less severe disenfranchisement. These findings demonstrate the need to address the legacy of structural racism at the state level to reduce mental distress for US youth.

Mental health from childhood to adolescence predicts excessive weight and body composition at 18 years

ObjectiveTo investigate the association of mental health in childhood and adolescence with four outcomes at 18 years: ultra-processed food (UPF) consumption, body mass index (BMI), excessive weight (EW), and body composition, including fat mass (FM) and fat free mass (FFM) in kg, FM index (FMI) and FFM index (FFMI) in kg/m2. MethodsCohort study in which The Development and Well-Being Assessment (DAWBA) (6 and 11 years) and the MINI International Neuropsychiatric Interview (MINI) (18 years) provided information on internalizing (INT), externalizing (EXT) and any mental disorder (ANY). The exposure was classified in: “never”, “at 6 and/or 11 years”, “at 18 years only” and “at 6, 11, and 18 years”. Linear and logistic regression were run. All analyses were stratified by sex. ResultsA total of 2722 participants were analyzed. At 18 years, female with EXT disorders at 6 and/or 11 years presented higher BMI (β: 1.70; 0.18–3.23), FM (β: 4.74; 1.42–8.06), and FMI (β: 1.53; 0.28–2.79) than those who never had. The odds of EW at 18 years was also higher in females with EXT disorders at 6 and/or 11 years (OR: 3.39; 1.56–7.36) and at the three time points (OR: 7.08; 1.69–29.59). Males with EXT disorders at 6 and/or 11 years presented higher FM (β: 4.45; 1.85–7.06) and FMI (β: 1.47; 0.63–2.31). ConclusionsAmong children and adolescents showing symptoms of EXT disorders, weight should be monitored carefully, thus ultimately contributing to reduce the burden of EW in adolescence.