Health Problems In Youth Research Articles

Negative life events and stress sensitivity in youth’s daily life: an ecological momentary assessment study

PurposeNegative life events (LEs) are associated with mental health problems in youth. However, little is known about underlying mechanisms. The aim of the study was to investigate whether exposure to LEs modifies stress sensitivity in youth’s daily life.MethodsEcological Momentary Assessment (EMA) was used to assess stress sensitivity (i.e., association of momentary stress with (i) negative affect and (ii) psychotic experiences) in 99 adolescents and young adults (42 service users, 17 siblings, and 40 controls; Mage 15 years). Before EMA, exposure to LEs (e.g., intrusive threats, experience of loss, serious illness) was assessed.ResultsLifetime as well as previous-year exposure to LEs modified stress sensitivity in service users: they experienced more intense negative affect and psychotic experiences in response to stress when high vs. low exposure levels were compared. In contrast, controls showed no differences in stress sensitivity by exposure levels. Looking at specific types of LEs, controls showed less intense negative affect in response to stress when high vs. low exposure levels to threatening events during the last year, but not lifetime exposure, were compared. In siblings, no evidence was found that LEs modified stress sensitivity.ConclusionStress sensitivity may constitute a putative risk mechanism linking LEs and mental health in help-seeking youth, while unfavourable effects of LEs on stress sensitivity may attenuate over time or do not occur in controls and siblings. Targeting individuals’ sensitivity to stress in daily life using novel digital interventions may be a promising approach towards improving youth mental health.

Home alone: Social functioning as a transdiagnostic marker of mental health in youth, exploring retrospective and daily life measurements

PurposeEarly detection and intervention of mental health problems in youth are topical given that mental disorders often start early in life. Young people with emerging mental disorders however, often present with non-specific, fluctuating symptoms. Recent reports indicate a decline in social functioning (SF) as an early sign of specific emerging mental disorders such as depression or anxiety, making SF a favorable transdiagnostic approach for earlier detection and intervention. Our aim was to investigate the value of SF in relation to transdiagnostic symptoms, and as a predictor of psychopathology over time, while exploring traditional retrospective versus innovative daily diary measurements of SF in youth. MethodParticipants (N = 75) were 16–25 years of age and presented early stage psychiatric symptomatology. Psychiatric symptoms, including anxiety and depression, as well as SF -both in retrospect and in daily life- were assessed at two time points and analyzed cross-sectionally and longitudinally. ResultsA significant and negative association between SF and all psychiatric symptoms was found, and SF was a significant predictor of change in general psychiatric symptoms over time. Results were only significant when SF was measured traditionally retrospective. ConclusionThis study confirms a distinct relation between SF and transdiagnostic psychiatric symptoms in youth, even in a (sub)clinical population, and points towards SF as a predictor of transdiagnostic psychiatric symptoms. Further research is needed to learn more about the added value of daily life versus retrospective measurements.

The Effect of Early Life Health on Later Life Home Care Use: The Mediating Role of Household Composition

In this paper we estimate the effect of early life health on home care use later in life, and we analyse whether this effect is mediated through household composition. We use Dutch administrative data on men born in 1944-1947 who were examined for military service between 1961-1965 and we link them to national data on non-residential care in the period 2004-2013 and data on house- hold status information for the years 1999-2014. We account for confounding factors that influence both early life health and later life home care use. We also account for selective attrition. Our empirical findings show that general health problems in youth is an important health predictor for later life home care use. A large portion of this effect is an indirect effect running through changes in partnership status.

Mental health comorbidities following peer victimization across childhood and adolescence: a 20-year longitudinal study.

Peer victimization is associated with a wide range of mental health problems in youth, yet few studies described its association with mental health comorbidities. To test the association between peer victimization timing and intensity and mental health comorbidities, we used data from 1216 participants drawn from the Quebec Longitudinal Study of Child Development, a population-based birth cohort. Peer victimization was self-reported at ages 6-17 years, and modeled as four trajectory groups: low, childhood-limited, moderate adolescence-emerging, and high-chronic. The outcomes were the number and the type of co-occurring self-reported mental health problems at age 20 years. Associations were estimated using negative binomial and multinomial logistic regression models and adjusted for parent, family, and child characteristics using propensity score inverse probability weights. Youth in all peer victimization groups had higher rates of co-occurring mental health problems and higher likelihood of comorbid internalizing-externalizing problems [odds ratios ranged from 2.06, 95% confidence interval (CI) 1.52-2.79 for childhood-limited to 4.34, 95% CI 3.15-5.98 for high-chronic victimization] compared to those in the low victimization group. The strength of these associations was highest for the high-chronic group, followed by moderate adolescence-emerging and childhood-limited groups. All groups also presented higher likelihood of internalizing-only problems relative to the low peer victimization group. Irrespective of timing and intensity, self-reported peer victimization was associated with mental health comorbidities in young adulthood, with the strongest associations observed for high-chronic peer victimization. Tackling peer victimization, especially when persistent over time, could play a role in reducing severe and complex mental health problems in youth.

Psychological well-being in childhood: The role of trait emotional intelligence, regulatory emotional self-efficacy, coping and general intelligence.

Given the increase of mental health problems in youth, focusing on the promotion of psychological well-being is essential. Among the variables recognized as linked to children's psychological well-being, trait emotional intelligence, emotional self-efficacy and coping seem to be crucial, whereas the role played by intelligence is still controversial. In the present study, we explored the combined effects of these variables, aimed at disentangling their unique contribution to psychological well-being of 74 children (41 males, mean age: 9.03years). We administered verbal and reasoning tests as intelligence measures and self-report questionnaires to assess trait emotional intelligence, regulatory emotional self-efficacy, coping styles, psychological well-being. Correlations revealed two independent clusters of variables: a first cluster including intelligence indexes and a second cluster including psychological well-being, trait emotional intelligence, regulatory emotional self-efficacy and adaptive coping styles. Hierarchical regression analyses showed that only trait emotional intelligence and positive restructuring coping style significantly contributed to psychological well-being. This study highlights that, unlike general intelligence, trait emotional intelligence was associated to psychological well-being, whereas coping styles play a negligible role in explaining this relationship. These findings are valuable in identifying the most relevant factors for children's adjustment and in enhancing emotion-related aspects in interventions for psychological well-being promotion.

Promoting youth mental health during the COVID-19 pandemic: A longitudinal study.

The COVID-19 pandemic has introduced novel stressors into the lives of youth. Identifying factors that protect against the onset of psychopathology in the face of these stressors is critical. We examine a wide range of factors that may protect youth from developing psychopathology during the pandemic. We assessed pandemic-related stressors, internalizing and externalizing psychopathology, and potential protective factors by combining two longitudinal samples of children and adolescents (N = 224, 7-10 and 13-15 years) assessed prior to the pandemic, during the stay-at-home orders, and six months later. We evaluated how family behaviors during the stay-at-home orders were related to changes in psychopathology during the pandemic, identified factors that moderate the association of pandemic-related stressors with psychopathology, and determined whether associations varied by age. Internalizing and externalizing psychopathology increased substantially during the pandemic. Higher exposure to pandemic-related stressors was associated with increases in internalizing and externalizing symptoms early in the pandemic and six months later. Having a structured routine, less passive screen time, lower exposure to news media about the pandemic, and to a lesser extent more time in nature and getting adequate sleep were associated with reduced psychopathology. The association between pandemic-related stressors and psychopathology was reduced for youths with limited passive screen time and was absent for children, but not adolescents, with lower news media consumption related to the pandemic. We provide insight into simple, practical steps families can take to promote resilience against mental health problems in youth during the COVID-19 pandemic and protect against psychopathology following pandemic-related stressors.

Mental health problems in youth and later receipt of social assistance: do parental resources matter?

ABSTRACT In this article, we study the association between mental health problems in adolescence and early adulthood and later receipt of social assistance in the capital region of Finland. Using register data and following a cohort of adolescents to their early adulthood, we also examine whether the strength of this association varies according to household income during adolescence. We find that mental health problems from the ages of 16–17 and thereafter were associated with the receipt of social assistance at age 24, and more strongly among those with lower household income during their adolescence. Importantly, the same disorder groups emerged as the most important ones in predicting the use of social assistance across income quintiles. In this sense, we find similarity regardless of parental resources. This evidence is important for better understanding the mechanisms between circumstances during adolescence and later socioeconomic outcomes, including benefit use, yet the underlying factors should be studied further.

Is interpretation bias for threat content specific to youth anxiety symptoms/diagnoses? A systematic review and meta-analysis.

Anxiety is the most common mental health problem in youth. Numerous studies have identified that youth anxiety is associated with interpretation bias or the attribution of threatening meaning to ambiguity. Interpretation bias has been proposed as a mechanism underlying the development and maintenance of pediatric anxiety. Theoretically, interpretation bias should be content-specific to individual youth anxiety symptom domains. However, extant studies have reported conflicting findings of whether interpretation bias is indeed content specific to youth anxiety symptoms or diagnoses. The present meta-analysis aimed to synthesize the literature and answer the question: is the relationship between interpretation bias and anxiety content specific? Search of PubMed and PsycINFO databases from January 1, 1960 through May 28, 2019 yielded 9967 citations, of which 19 studies with 20 comparisons and 2976 participants met eligibility criteria. Meta-analysis with random effects models was conducted to examine an overall effect (Pearson r) between anxiety domain and content-specific interpretation bias in single sample studies, and an overall effect size difference (Cohen's d) in studies comparing anxious to non-anxious youth. Results support a content specific correlation between interpretation bias and anxiety symptom domain in single sample studies (r = 0.18, p = 0.03). However, it is currently undetermined whether this relationship holds in studies that compare the relationship between content-specific interpretation bias and anxiety in anxious versus non-anxious youth. A variety of methodologic considerations across studies are discussed, with implications for further investigation of interpretation bias and youth anxiety.

What works for mental health problems in youth? Survey of real-world experiences of treatments and side effects.

Despite youth being the most common age group for onset of mental disorders, there is less knowledge on the benefits and harms of treatments in young people. In addition, efficacy data from randomized controlled trials may not generalize to how treatment works outside of research settings. This study aimed to investigate young people's perceived effectiveness of different treatments for mental health problems, the professionals who delivered these, and the experience of negative effects. We developed a consumer report website where young people who were ever diagnosed with a mental disorder provided ratings on the helpfulness or harmfulness of different types of professionals, mental health treatments (medical, psychological complementary/alternative) and self-help strategies, and whether they had experienced particular negative effects. Here, 557 young people aged 12-25 years, who were recruited from English-speaking, high-income countries, provided 1258 ratings of treatments. All treatments showed varied perceptions of effectiveness. Medical and psychological treatments were rated moderately helpful on average with low rates of harmfulness. Self-help strategies were rated as being as helpful as professional treatments. Side effects related to the head or mind (e.g., concentration difficulties, inability to feel emotions, depression and irritability) were the most common across all types of medicines. For psychological treatments, treatment being too expensive and feeling worse at the end of a session were the most commonly reported negative effects. Study findings may be a useful guide to clinicians, researchers, young people and their families about what is likely to work in real-world settings.

Burden of mental health problems: quality of life and cost-of-illness in youth consulting Dutch walk-in youth health centres

Background Little is known about the burden of (sub-threshold) mental health problems in youth. Aim To examine the burden of mental health problems in terms of health-related quality of life (HRQoL) and cost-of-illness, for first visitors of the Dutch youth walk-in centres (@ease). Method A bottom-up, prevalence-based burden of disease study from a societal perspective. HRQoL was assessed through the EuroQoL (EQ-5D-5L), and cost-of-illness via items about truancy and health care utilization. Results Participants (N = 80) showed a decreased HRQoL compared to the general population of Dutch youth. In the three months prior to their 1st attendance, participants skipped on average 4.11 days of school and had 1.03 health care visits, leading to total costs of €512.64 per person. Females had significantly higher health care costs and lower HRQoL. Health care use was lower in those not speaking the Dutch language. Living alone was a significant predictor of truancy (costs), and therefore total costs. Conclusions Mental health problems in youth consulting @ease have a considerable impact on the individual’s HRQoL, and an economic impact on society, yet almost 75% is not receiving care. A lack of interventions in this critical period in life may have major lifelong consequences.

Psychiatric disorders in children and adolescents in a middle-income Latin American country

BackgroundChild and adolescent mental health has scarcely been studied in developing countries, though it is an important aspect of health. Mental health problems in youth often continue into adulthood if not diagnosed or treated in time.MethodsThe Sistema de Evaluación de Niños y Adolescentes (SENA) [Child and Adolescent Evaluation System] was used to evaluate mental health indicators in a sample of students in Northern Chile. Two age-appropriate versions of the assessment were applied to a total sample of 5043 students, which included an elementary education sample of 1953 schoolchildren from fourth grade through sixth grade (ages 8 to 13 years), and a Secondary School sample of 3090 schoolchildren from seventh grade (the last year of elementary school) through the last year of Secondary school (senior high school) (ages 12 to 19 years). For each group, the version of the assessment used was determined by the students’ grade level. Both samples included municipal, government-subsidized, and private schools.ResultsIn this student population, depression, anxiety, and behavioral disorders were the main mental health problems identified, and indicators revealed a progressive increase in cases over the years, coinciding with the global epidemiological scenario. Males showed a greater presence of externalizing behaviors related to mental health problems associated with aggression and defiant behavior. However, females showed the highest number of mental health issues overall, especially regarding problems related to internalization. There are significant differences between school types.ConclusionsOur sample population analysis indicates that early intervention is necessary for the diagnosis and treatment of youth, with the goal of reducing the probability that psychiatric disorders will be prolonged, evolving, and worsening in adulthood.

Social Cognitions and Mental Health as Predictors of Adolescents\u2019 Mindfulness Practice

ObjectivesWhile practicing mindfulness can potentially mitigate and prevent mental health problems among adolescents, mindfulness programs delivered in schools do not uniformly lead to uptake of mindfulness practice. This low adherence threatens the internal validity of mindfulness trials and may hinder the alleviation of mental health problems in youth who fail to take up potentially effective techniques. Consequently, it is vital to investigate what predicts uptake of independent mindfulness practice in such interventions.MethodsUsing path analyses, this study investigates whether social cognitions from the Reasoned Action Approach and initial mental health predict mindfulness practice among 1646 adolescent recipients of the school-based Healthy Learning Mind mindfulness intervention.ResultsIn line with the Reasoned Action Approach, descriptive and injunctive norms, and positive and negative outcome expectations predicted intention to practice mindfulness (R2 = .37, p < .001), which in turn predicted different measures of mindfulness practice itself (R2 = .09–.17, p < .001). Neither perceived behavioral control nor mental health variables (depressive symptoms, internalization and externalization of difficulties, and resilience: R2 = .01, p > .05) were associated with mindfulness practice after the intervention.ConclusionSocial norms and outcome expectations are potential intervention targets to increase mindfulness practice motivation and behavior among adolescents.

A One-Season Prospective Study of Illnesses, Acute, and Overuse Injuries in Elite Youth and Junior Track and Field Athletes.

Background: In high-level adult athletes, injury incidences and characteristics have been reported during international championships and during one season. Youth track and field athletes are also exposed to injury risk, although less information is available on this specific population, as well as on illness risk.Aim: To determine the prevalence of health problems (i.e., illnesses, acute, and overuse injuries) in high level Youth and Junior Track & Field athletes.Method: During the 2015–16 athletics season (30 weeks from December 2015 to July 2016), we conducted a prospective cohort study on a population of Youth and Junior Irish national level athletes, during which athletes were asked to complete a weekly web-based questionnaire (Oslo Sports Trauma Research Center questionnaire on health problems) regarding their health problems.Results: A total of 70 athletes participated (37 male and 33 female athletes), with an average weekly response rate of 71%. The average weekly prevalence for all athletes was 27% (95%CI 17 to 38%) for all health problems, and 11% (95%CI 3 to 18%) for substantial health problems. Average prevalence varied significantly between endurance and explosive disciplines: a higher prevalence of all and substantial health problems and all and substantial overuse injuries was found in endurance disciplines. A higher prevalence of acute injuries was found in explosive disciplines. Characteristics of acute and overuse injuries differed according to sex and discipline: hamstring strain/cramps/spasms was the main injuries in explosive disciplines, and knee tendinopathy and lower leg strain/cramp/spasms in endurance disciplines, trunk cramps/spasms being frequent in both disciplines. Upper respiratory tract problems were the most commonly reported illnesses regardless of sex and disciplines.Conclusion: This study provides important information regarding the extent of health problem in Youth and Junior track and field athletes. This could help orient injury prevention measures. For injuries, it should be focused on muscle injuries, especially located on the hamstring, calf, and trunk. For illness, prevention measures could include: screening tests for airway problems, but also general illness prevention measures (e.g., drinking regularly, eating “safe” food, regular hand washing, decreasing contact with sick people, avoiding dehydration).

Mindset and perseverance of adolescents with intellectual disabilities: Associations with empowerment, mental health problems, and self-esteem

BackgroundMindset refers to the implicit assumptions about the malleability of attributes such as intelligence, behavior, and personality. Previous research has shown that people endorsing a growth mindset show better academic and mental health outcomes than those with a fixed mindset. However, little is known about the mindset of youth with intellectual disabilities (ID) and its association with mental health. MethodsAdolescents with (n = 247) and without (n = 96) mild to borderline ID completed questionnaires about mindset and perseverance, empowerment, mental health problems, and self-esteem. ResultsAdolescents with ID endorse a more fixed mindset of emotion and behavior than adolescents without ID. No significant differences were found for mindset of intelligence and perseverance. In addition, within the group of youth with ID some differences in mindset and perseverance were found based on level of intellectual disability, gender, and comorbidities, but not for age. Finally, a growth mindset of emotion and behavior and perseverance, but not mindset of intelligence, were negatively related to mental health problems in youth with ID. Conclusion and implicationsOverall, findings indicate that teaching youth with ID a growth mindset of emotion and behavior and perseverance may be a potentially successful endeavour to improve mental health in adolescents with ID.

Motivation for sports participation, injury prevention expectations, injury risk perceptions and health problems in youth floorball players

PurposeDescribe the motivation for floorball participation, injury prevention expectations, injury risk perceptions and prevalence of health problems in youth floorball players at the start of the season.MethodsThis cross-sectional survey is part of a larger Sport Without Injury ProgrammE (SWIPE) project and provides baseline data before a cluster randomised controlled trial of an injury prevention program (Knee Control). A baseline survey (online and paper based) was collected from 47 teams with 471 youth floorball players from two provinces of Sweden before the start of the 2017 season.ResultsThe mean age for 140 females and 331 males was 13.7 (± 1.5) and 13.3 (± 1.0) years, respectively. The two most significant motivators for floorball participation were being part of the team (82% females, 75% males) and friends (65% females, 70% males). Fractures (84% females, 90% males), eye injuries (90% females, 83% males) and concussion (82% females, 83% males) were perceived as the most severe injuries. 93% of players believed that sports injuries can be prevented, while 74% believed it is unlikely that they will sustain an injury. Existing health problems at the beginning of the season were prevalent in 33% of players, with 65% being injuries and 35% illnesses. 17% of existing injuries at the start of the season caused time-loss from play and 17% required medical attention.ConclusionSocial aspects were the greatest motivators for floorball participation in youths, suggesting that these factors are important to retain sports participants. The high number of health problems in youth is a concern; as such more effort, resources and priority should be given to sports safety programs. Many players believed that sports injuries can be prevented, possibly providing a fertile ground for implementation of such programs.Level of evidenceIV.

Desired Features of a Digital Technology Tool for Self-Management of Well-Being in a Nonclinical Sample of Young People: Qualitative Study.

BackgroundAdaptive coping behaviors can improve well-being for young people experiencing life stressors, while maladaptive coping can increase vulnerability to mental health problems in youth and into adulthood. Young people could potentially benefit from the use of digital technology tools to enhance their coping skills and overcome barriers in help-seeking behaviors. However, little is known about the desired digital technology use for self-management of well-being among young people in the general population.ObjectiveThis is a small, qualitative study aimed at exploring what young people desire from digital technology tools for the self-management of their well-being.MethodsYoung people aged 12-18 years were recruited from the general community to take part in semistructured interviews. Recorded data from the interviews were transcribed and analyzed using inductive thematic analysis.ResultsIn total, 14 participants were recruited and completed the study, with a mean age of 14.6 years (female n=3). None of the participants reported using any digital tools specifically designed to manage well-being. However, as indicated through the emerged themes, young people used digital technology to reduce their stress levels and manage their mood, mainly through games, music, and videos. Overall, identified themes showed that young people were keen on using such tools and desired certain facets and features of an ideal tool for self-management of well-being. Themes related to these facets indicated what young people felt a tool should do to improve well-being, including being immersed in a stress-free environment, being uplifting, and that such a tool would direct them to resources based on their needs. The feature-based themes suggested that young people wanted the tool to be flexible and enable engagement with others while also being sensitive to privacy.ConclusionsThe young people interviewed in this study did not report engaging with digital technology specialized to improving well-being but instead used media already accessed in their daily lives in order to self-manage their psychological states. As a result, the variety of coping strategies reported and digital tools used was limited to the resources that were already being used for recreational and social purposes. These findings contribute to the scarce research into young people’s preferred use of digital technology tools for the self-management of their well-being. However, this was a small-scale study and the current participant sample is not representative of the general youth population. Therefore, the results are only tentative and warrant further investigation.

Adolescent depression: Study protocol for a randomized, controlled, double-blind multicenter parallel group trial of Bright Light Therapy in a naturalistic inpatient setting (DeLight)

BackgroundDepressive disorders are among the most prominent health problems in youth. Even with the best available pharmacological and non-pharmacological treatments, remission rates are low. Without early treatment, depression in youth is associated with a high risk of symptom progression, chronicity, co-morbidity, and suicidal behavior. Thus, adolescent depression is a prime candidate for innovation in treatment. In depressive adults, meta-analytic evidence has proven that bright light therapy (BLT) is a potent low-threshold intervention, promising due to easy application, low side effects, and optimized compliance. In adolescents, studies with small samples show promising effects. This randomized controlled trial will examine the effectiveness of BLT in youth inpatients.Methods/designIn this randomized, controlled, double-blind multicenter parallel group trial, morning BLT is applied for four weeks in addition to treatment as usual (TAU) for depressed youth inpatients (daily morning exposure to bright light via light-emitting glasses, 10,000 lx, for 30 min) and will be compared to a control condition (placebo light treatment, red light, identical light glasses). The primary objective is to assess whether BLT reduces symptoms of depression in youth with greater effect compared to placebo light therapy. Secondary objectives are to examine the impact of BLT on responder status, application of antidepressant medication, and further depression-related symptoms (sleep, activity, quality of life, satisfaction with health, general psychopathology, alertness, and circadian function). N = 224 patients will be recruited in a naturalistic inpatient setting. A follow-up will be carried out after three and six months.DiscussionThe study aims to discuss and evaluate BLT as an additive method supporting standardized clinical procedures dealing with severe to moderate depressive symptoms in youth.Trial registrationGerman Clinical Trials Register, DRKS00013188. Registered on November 30, 2017.

Global burden of mental disorders among children aged 5\u201314\xa0years

BackgroundThe global burden of disease (GBD) study provides information about fatal and non-fatal health outcomes around the world.MethodsThe objective of this work is to describe the burden of mental disorders among children aged 5–14 years in each of the six regions of the World Health Organisation. Data come from the GBD 2015 study. Outcomes: disability-adjusted life-years (DALYs) are the main indicator of GBD studies and are built from years of life lost (YLLs) and years of life lived with disability (YLDs).ResultsMental disorders are among the leading causes of YLDs and of DALYs in Europe and the Americas. Because of the importance of infectious diseases, mental disorders appear marginal in Africa for YLLs although they play an important role in YLDs there. Because the epidemiological transition that has taken place in Europe and the Americas (i.e., a switch from acute and infectious conditions to chronic and mental health issues) is likely to happen sooner or later across the entire planet, mental health problems in youth are likely to become one of the main public health challenges of the twenty-first century.ConclusionThese results should improve health care if policy-makers use them to develop health policies to meet the real needs of populations (especially children) today.

The Effect of Early Life Health on Later Life Home Care Use: The Mediating Role of Household Composition

In this paper we estimate the effect of early life health on home care use later in life, and we analyse whether this effect is mediated through household composition. We use Dutch administrative data on men born in 1944-1947 who were examined for military service between 1961-1965 and we link them to national data on non-residential care in the period 2004-2013 and data on house- hold status information for the years 1999-2014. We account for confounding factors that influence both early life health and later life home care use. We also account for selective attrition. Our empirical findings show that general health problems in youth is an important health predictor for later life home care use. A large portion of this effect is an indirect effect running through changes in partnership status.

Close Friendships and Mental Health of Korean American Adolescents: The Moderating Effect of Personality

During adolescence, the youth increasingly rely on peers for intimacy and support. Since traditional Korean values emphasize the centrality of the family, this shift in emotional attachment may be especially challenging for Korean American youth. However, it is not known whether adolescents who lack a supportive close friendship may be at greater risk for mental health problems. The aims of this study were to determine whether the quality of the adolescents’ closest friendship is associated with the mental health of Korean American adolescents, and whether specific personality traits of the youth may moderate any association between the quality of their friendships and their mental health problems. This cross-sectional study included 138 Korean American adolescents from community settings in California. A demographic questionnaire, the Relationship Quality Questionnaire, the NEO Five-Factor Inventory-3, and the Youth Self Report were completed by adolescents. Hierarchical regression analyses were used to examine the aims. Quality of the closest friendship was not a significant predictor of mental health problems for youth in general. However, the personality trait of agreeableness did predict better mental health. Agreeableness also showed a moderating effect, indicating that for youth who had less agreeable, more antagonistic personalities, a high quality relationship with their best friend was associated with fewer mental health problems. Longer residence in the U.S. was also related to better mental health. Findings suggest the need for early identification of youth who have poor relationships with close friends or a more antagonistic personality. It may be especially important to provide supportive mental health interventions for Korean American adolescents with these combined risks.