Adolescent Mental Health Problems Research Articles

44.2 CHATogether: Virtual Theater Productions between Adolescents and Their Parents Narrow Acculturative Gaps and Address Mental Health Stigma

Acculturation gaps often refer to the significant discrepancy between an immigrant parent and their children due to communication dysfunction and differential cultural values. Such gaps may turn into intergenerational conflicts during the pandemic when a family is packed in a cabin-fever household. Acculturation gaps have shown to be associated with depression and other mental health problems in adolescents of immigrant families. To address this, we introduce a digital theater program (DTP) as part of the initiatives from a co-op organization, Yale Compassionate Home, Action Together (CHATogether).

10.4 Development of Measurement-Based Care in a Mental Health Setting of Children and Adolescents

There is a substantial “voltage gap” between the outcomes of randomized controlled trials and everyday clinical outcomes across a broad range of child and adolescent mental health problems. While measurement-based care (MBC), the systematic administration of symptom rating scales and use of the results to drive clinical decision making at the level of the individual patient, has the potential to improve outcomes, there are still relatively few examples of MBC being successfully implemented within the field.

1.91 A Group Intervention to Improve Caregiver-Adolescent Relationships in the Context of Adolescent Depression

Although conflict with parents was previously viewed as part of typical adolescent development, high levels of conflict are not normative and are often present alongside adolescent mental health problems, including depression. Secondary analyses of data from clinical trials suggests that parent-adolescent conflict may be a major factor that limits adolescent response to evidence-based depression treatments. However, no existing interventions have demonstrated efficacy for reducing the parent-adolescent relationship problems commonly present in adolescents with depression.

Role of Self-Esteem in Punitive Parenting and Psychological Reactions of Abuse and Neglect in Adolescents

The objective of the study was to examine the moderating role of self-esteem in the relationship between punitive parenting and psychological reactions to abuse and neglect. The sample of the study was 305 (Girls=49%, Boys=50%) adolescents with the age range of 12-16 years (M=14.25, SD=1.47) of class 6th -10th of 3 boys and 4 girls schools selected through multistage sampling technique. Culturally developed punitive parenting scale, self-esteem scale, and psychological reactions of abuse and neglect scale were administered. Results were discussed in light of cultural expressions and indicators of self-esteem, punitive parenting, and psychological reactions to abuse and neglect. Results suggested that self-esteem significantly moderates the relationship between punitive parenting and psychological reactions to abuse and neglect (?=.013, SE. = - .005, p<.001). Regression analysis revealed that punitive parenting is a positive predictor (SE=.45, p<.001) of psychological reactions to abuse and neglect whereas self-esteem negatively predicts (?=-.006; SE=.08) psychological reactions to abuse and neglect in the association with punitive parenting in adolescents. Study findings suggest that punitive parenting significantly contributes to increasing psychological reactions to abuse and neglect in adolescents therefore the area of parenting needs noteworthy concerns to reduce mental health problems in adolescents.

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

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

Development of a Mobile Application for Detection of Adolescent Mental Health Problems and Feasibility Assessment with Primary Health Care Workers

Introduction: There has been a sharp increase in the use of digital health interventions in global health, particularly mobile health applications, in recent years. The extreme shortage of health care providers trained in mental health screening and intervention in low- and middle-income countries raises questions about the applicability of mobile applications to deliver these services due to their accessibility and availability. This exploratory paper describes the development and feasibility assessment of a mobile screening application for the detection of mental disorders among adolescents in Zambia and South Africa. Methods: Eighty-two health care workers (HCW) working in primary care evaluated the acceptability and practicality of the mobile screening application after receiving brief training. The evaluation included questions from the Mobile Application Rating Scale (MARS) as well as open-ended questions. Results: The acceptability of the screening app was high and study participants were positive about using the app in routine care. Problems with internet connectivity, and time and staff constraints were perceived as the main barriers to regular use. Conclusion: HCW in primary care were able and willing to use a mobile screening app for the detection of mental health problems among treatment-seeking adolescents. Implementation in clinical practice needs to be further evaluated.

Multidimensional poverty and adolescent mental health: Unpacking the relationship

Extensive research suggests that poverty is associated with adolescent mental health problems. However, studies typically focus on monetary poverty and have not examined how other dimensions of poverty relate to adolescent mental health. This study examines the association between multidimensional poverty and mental health among adolescents using a Multidimensional Poverty Index. Based on data from the National Mental Health Survey in Colombia, we show that adolescents living in multidimensionally poor households have 50% higher risk of having mental health problems compared to adolescents in non-poor households. We unpack and assess the relation between each of the dimensions of poverty and mental health, and whether deprivations directly experienced by the adolescent are more strongly associated with mental health problems than deprivations experienced by other household members. Individual deprivations associated with human capital linked to schooling, work, health insurance and employment are more strongly associated with adolescent mental health problems than material deprivations. Lagging behind in school and working while studying has the strongest association with adolescent mental health problems. Results suggest that public policies that address dimensions of poverty associated with adolescents human capital accumulation may be critical to address mental health problems among adolescents.

Effect of Health Behaviors Practice on Mental Health in Adolescents

Objectives: The study aimed to investigate the effect of health behaviors practice on mental health in adolescents. Methods: Data from 16th (2020) Korea Youth Risk Behavior Web-based Survey were used. The study sample included 54,948 middle and high school students. The data were analyzed using Rao-Scott χ<sup>2</sup>, t-test, and complex samples logistic regression. Results: The prevalence of subjects with anxiety, depression, and suicidal ideation was 9.2%, 25.2%, and 10.9%, respectively. Health behaviors practice such as smoking, drinking, weight control, exercise, eating breakfast, sufficient sleep, and fruit intake were found to be significantly related to mental health. After controlling general characteristics, mental health factors such as anxiety, depression, and suicidal ideation were influenced by health behaviors practice. Conclusions: Interventions, including comprehensive health behaviors, should be strengthened to prevent mental health problems in adolescents.

The Legacy of Mental Distress Following Physical Illness in Childhood: Findings From the Australian Temperament Project.

Childhood physical illnesses have been associated with heightened risk for mental health problems in adolescence and young adulthood; however, little is known about the natural history of this relationship. Here, we examine the nature of mental health adjustment to illness from diagnosis in childhood into adolescence and young adult life. Data were drawn from a large population-based cohort. Parents reported whether their child had a physical illness at 5-6 and 7-8 years and whether they believed their child was so sick it was thought they might die. Depression and anxiety symptoms were reported by parents (for children 7-10 years) and self-reports (11-28 years). A total of 1,001 (56%) parents reported their child had a physical illness. Of these parents, 143 (8%) believed their child might die. Findings indicated there was some evidence of higher levels of depressive and anxious symptoms across late childhood and into early adolescence for those reporting a physical illness in childhood. A similar pattern was observed for those who were so sick it was thought they might die, although symptoms were elevated to a greater extent. Although physical illness in middle childhood is associated with higher levels of depressive and anxious symptoms, by early adolescence, these differences diminish, indicating a process of adaptation that persists into young adulthood. This suggests a potentially sensitive period of adjustment to illness for some, especially for children who it was feared might die. Additional psychosocial assessment and support may be warranted across the "acute" illness period.

Perceived causal symptom network of adolescent mental health issues

Adolescent mental health is difficult to capture in categories such as depression or specific anxiety disorders. An alternative is to approach psychiatric symptoms as causal networks, potentially revealing feedback loops that maintain a pathological state. One approach to creating such networks, implemented in the PECAN methodology, is to ask adolescents about their perceptions of the causes to their symptoms. For this purpose, a transdiagnostic item list was created, and adolescents who screened positive for depression (N = 55) completed twice in two weeks a survey quantifying perceptions of causality between their mental health problems. A network that was averaged across all participants was reliable and revealed three strong feedback loops: a first loop running through stress, insomnia, fatigue, procrastination, and back to stress; a second loop between stress and overthinking; and a third loop between stress and procrastination. Although all adolescents in the study screened positive for depression, symptoms of depression were not particularly central to the network. Instead, the most central symptoms were procrastination and overthinking. The average test-retest reliability for individual networks was low, limiting clinical application. In conclusion, PECAN was found to be reliable and useful when creating a group-level network of adolescent mental health problems. While informative at a group level, the method should be improved before it can be used to inform treatment at the individual level.

Loneliness, internalizing symptoms, and inflammatory markers in adolescent COVID‐19 survivors

BackgroundConcerns about the psychiatric sequelae after COVID‐19 infection have increased as the pandemic spreads worldwide. The increase in self‐isolation during this pandemic period has also revealed the importance of feelings of loneliness. This study aimed to examine the relationship between baseline inflammation levels, internalizing symptoms, and feelings of loneliness in adolescent COVID‐19 survivors in the long term.MethodsA total of 74 adolescents (41 girls, 55.4%, mean age 14.88) and their parents were included in the study. This cross‐sectional study assessed internalizing symptoms via Revised Children's Anxiety and Depression Scale (RCADS) and feelings of loneliness using the UCLA‐loneliness scale. Baseline inflammatory markers at COVID‐19 diagnosis were collected. Logistic regression analysis was used to determine predictors for depression in adolescents.ResultsThe most common disorder was Major Depressive Disorder (MDD) (25.7%), and 33.8% of the adolescents were in the clinical range in at least one internalizing domain. Baseline C‐Reactive Protein (CRP) levels correlated weakly with MDD scores. Loneliness scores correlated with all internalizing symptoms, strong association with MDD scores. Loneliness, anxiety, and parental anxiety were associated with an increased likelihood of MDD. Baseline CRP positivity did not predict MDD in adolescent COVID‐19 survivors.ConclusionsThis study indicates that anxiety, loneliness, and parental anxiety play an important role in adolescents' experience of depressive symptoms after COVID‐19 infection. Thus, screening parental psychopathology and loneliness in COVID‐19 survivors seems to be preventive for adolescent mental health problems.

In Case You Haven't Heard…

Despite the best efforts of clinicians and researchers for decades, there is still so much uncertainty about why some people develop mental disorders and others do not, the nonprofit journalism organization, The Conversation, reported Aug. 4. However, changes in the brain very likely offer the best clues to future mental health outcomes. The adolescent brain is particularly important in these predictions because brain changes during this time are rapid and dynamic, shaping a person's individual uniqueness. By monitoring and tracking brain changes as they happen, [researchers] contend that they can tackle emerging mental health problems in adolescence and target early treatment. The challenge is in accurately predicting the likelihood of a person developing a mental disorder before it happens. In a paper published recently in NeuroImage, study authors used data from the Australian Longitudinal Adolescent Brain Study that monitors changes in adolescents' brains. “We have been tracking adolescent brain development, using MRI scans, for several years,” stated researchers. “Our recent paper is the first to show [that] the uniqueness of an adolescent's brain (or their ‘brain fingerprint') can predict mental health outcomes. Brain fingerprinting could be the future of mental disorder prevention, allowing us to identify signs of concern in teenagers through brain imaging and intervene early, before illness develops.”

Association between patterns of eating habits and mental health problems in Chinese adolescents: A latent class analysis.

ObjectiveWe aimed to investigate the association between different eating habit patterns and mental health problems among Chinese middle and high school students, and further to estimate the interaction effect of different grouping variables on eating habits.MethodsOne thousand three hundred and forty-eight adolescents from Jilin Province in China were involved in this cross-sectional study. Mental health and eating habits were assessed using General Health Questionnaire and questions on Nutrition Knowledge, Attitude and Practice, respectively. Latent class analysis (LCA) was performed to identify eating habit patterns. Binary logistic regression and generalized linear models were used to explore the association between eating habit patterns, energy-adjusted nutrient intakes and mental health problems. Interaction analysis was performed to analyze the association between eating habits and mental health in different groups.ResultsBased on the LCA results, a 3-class parallel model was identified: 648 adolescents (48.1%) were classified in class-1 “Healthy Eating Behavior/Eating at Home,” 452 adolescents (33.5%) in class-2 “Healthy Eating Behavior/Eating at School” and 248 adolescents (18.4%) in class-3 “Unhealthy Eating Behavior/Random Place.” Compared with class-1, participants in class-2 and class-3 were at higher risk of mental health problems, especially for class-3 (p < 0.05). The energy and nutrient intakes by different latent classes showed that adolescents who ate unhealthy had lower daily intake of energy, protein, carbohydrate, fiber, Vitamins and minerals (p < 0.05). The interaction between age, sleep duration and different eating habits was statistically significant (p for interaction < 0.1).Conclusion“Unhealthy eating behavior/random place pattern” was positively correlated with mental health problems of adolescents. The adolescents with health diet were accompanied by fewer mental health problems, especially for that eating at home. And there were interactions between eating habits and age, sleep duration on the mental health problems.

Hubungan Antara Pola Asuh Orangtua, Teman Sebaya, Lingkungan Tempat Tinggal dan Sosial Ekonomi Dengan Kesehatan Mental Remaja

Introduction: Adolescence is a dynamic phase of development and undergoes many changes, these changes include physical, mental, social, and emotional changes. It is estimated that 10-20% of adolescents globally have mental health conditions, but these are still underdiagnosed and treated. In Indonesia, it is known that the estimated number of people with mental disorders worldwide is around 450 million, including schizophrenia (WHO, 2017). With Disability Adjusted Life Years (DALYs) is 4.5% and the cause of disability (YLDs) is greater than other diseases, namely 13.4%. Riskesdas (2018) results show that depressive disorders have started to occur since the adolescent age range (15-24 years), with a prevalence of 6.2%. The available data shows that there are not a few people with mental health disorders in adolescents. Factors that influence mental health problems in adolescents are the family environment, peers, school environment, community environment and social media. The family environment referred to here is parenting style, uncomfortable place to live, and lower socioeconomic status of parents. Objective: This study aims to determine the relationship between parenting patterns and adolescent mental health, the relationship between peers and adolescent mental health, the relationship between living environment and adolescent mental health, and the relationship between socioeconomic status and adolescent mental health. Methods: This type of research uses a quantitative approach with a descriptive type. The design of this study used a cross-sectional study method. The sampling technique used is the Non Probability Sampling technique, namely Purposive Sampling. The sample used was 121 students of SMKN 62 South Jakarta. The instruments used are the Self Reporting Questionnaire (SRQ) the and Parental Authority Questionnaire (PAQ). Used as 121 students at SMKN 62 South Jakarta. Results: The p-value between parenting and adolescent mental health is 0,029 &lt; 0,05. The results of the p-value of peers with adolescent mental health are 0,006 &lt; 0,05. The result of the p-value between the neighborhood and the mental health of adolescents is 0,042 &lt; 0,05. And the results of the p-value between the socio-economic and mental health of adolescents are 0,044 &lt;0,05. Conclusion: Of all the variables (parental parenting, peers, living environment, and socio-economic) that exist, the results show that all variables have a relationship with adolescent mental health.

Clinical, psychological, social, and family characterization of suicidal behavior in Chilean adolescents: a multiple correspondence analysis.

Introduction Suicide is the second leading cause of premature death in people between 15 and 29 years old and the third in young people between 15 and 19 years old. Adolescence is a critical period concerning mental health disorders since there is greater vulnerability to suicidal behaviors. The situation in Latin America is worrying, with Chile being one of the two countries where suicide rates of children and adolescents increase yearly. This study aims to analyze clinical, psychological, family, and social risk factors associated with suicidal behavior in a clinical sample of adolescents treated in the public health system of the Maule region. Methods The study design is cross- sectional. We used a sample of 388 adolescents between 10 and 21 years old admitted to the health system of the Maule Region. The participants were evaluated by applying five measuring instruments (The Barrat Impulsivity Scale, The Difficulties in Emotional Regulation Scale, The Depression, Anxiety and Stress Scale, The General Help-Seeking Questionnaire for mental health problems in adolescents, and The Columbia Suicide Severity Rating Scale) in addition to collecting social and family information and relevant clinical history from the medical records. Results The analysis allowed us to identify distinctive characteristics of adolescent suicidal behavior by describing clinical, psychological, and family social factors. Conclusions Adolescents with a history of suicide attempts are characterized by having suicidal ideation, anxious-depressive symptoms, stress, insomnia, and impulsiveness. Likewise, they report being non-religious, belonging to sexual minorities, and victims of sexual harassment and/or abuse.

Barriers to Seeking Psychotherapy for Mental Health Problems in Adolescents: a mixed method study

Given the large discrepancy between prevalence rates of mental disorders in adolescents and actual treatment rates, there is a need to understand what prevents this age group from seeking psychotherapy. We assessed the barriers to seeking psychotherapy in this age group, including their attitudes toward people with a mental disorder, using a convergent parallel mixed-methods design. Participants were 288 adolescents aged 12–21 years (M = 16.8 years, SD = 2.3; 37% identified as male, 63% as female, and 0% as nonbinary). Qualitative data were obtained with open-ended questions on barriers to initiating psychotherapy and attitudes toward people with a mental disorder. Barriers to seeking psychotherapy and information about psychotherapy were assessed with a questionnaire using a quantitative design. The qualitative assessment revealed as the main barriers fear of a negative interaction with a psychotherapist, fear of being confronted with their own emotions, self-stigma, and fear of public stigma. Further, lack of accessibility, lack of trust in the therapist, a desire for social distance from, and a negative attitude toward people with a mental disorder were associated with a decreased intention to initiate psychotherapy. Previous positive experience with a psychotherapist was a facilitator of seeking psychotherapy. We found gender differences, with higher desire for social distance and higher optimism bias scores as well as poorer mental health knowledge for participants identifying as male. Integrating results from both approaches results in further information for the improvement of prevention programs and interventions to lower barriers to seeking psychotherapy. Gender differences indicate a need for gender-role-specific interventions.

Universal prevention of depression at schools: dead end or challenging crossroad?

Universal school programmes aimed at the prevention of depression and other common mental health problems in adolescents are attractive because they are less stigmatising than targeted interventions, have a high...

Outcome evaluation of psychological interventions offered to adolescents seeking mental health services at the national referral and teaching hospital in Nairobi, Kenya

BackgroundLiterature highlights that adolescent mental health problems are amenable to treatment, specifically to psychological interventions. Unfortunately, there is a dearth of evidence on the services available for their management especially in low-middle-income contexts. This study aimed to highlight psychological interventions available to adolescents seeking mental health services at the National referral hospital in Kenya and to understand their effectiveness in the management of child and adolescent mental disorders. MethodsMaking use of a naturalistic, observational approach, we followed a cohort of adolescents (n ​= ​201) receiving talk therapy. Assessments were collected at the beginning and end of each session to assess patient outcomes and therapeutic alliance over the 12-month study period, with participants attending an average of three sessions. Analysis was carried out on the entire sample including descriptive and bivariate analyses, as well as analyses of clinical and reliable change. Sub-analysis was also carried out on a smaller sample who had a clinical diagnosis. ResultsScores on the Paediatric Symptom Checklist [M(SD) ​= ​51.1 (9.55)] showed our participants had high levels of impairment warranting further treatment. However, only 37.3% were assigned a clinical diagnosis. It was noted that the adolescents received multiple therapies. Our findings on outcome showed that there was statistically significant mean decrease in scores from intake to second follow-up on the self and clinician rated outcomes. Post hoc analysis with a Bonferroni adjustment revealed that outcome scores statistically significantly decreased from intake to second follow-up at 3.39 (95% CI, 1.61 to 5.17) on self-rated and 2.64 (95% CI, 1.38 to 3.9) on the clinician-rated scores. ConclusionOur findings illustrate mental health services, specifically psychotherapies offered to adolescents seeking care in a public institution are associated with alleviation of adolescent distress over time.

Individual and Spiritual Factors Contributing to the Social and Mental Health Problems of Adolescents in Malaysia

The rise of social issues among adolescents from time to time proves that the level of mental health among adolescents is alarming. Various factors should give serious attention to curb this issue from spreading. This study was conducted to explore the extent of individual and spiritual factors that cause social and mental health problems among adolescents. It uses a qualitative study approach through a case study strategy. Through interviews with respondents in an individual counseling session, this study involves the purposive sampling method aimed at eleven adolescents aged 16 to 20 years who are undergoing rehabilitation. The data obtained from the interviews were analyzed thematically using the Atlas.ti application. Data analysis enabled the identification of underlying themes that further contributed to the main themes for this study. Results show three main themes identified for individual factors: low self-esteem, social interest, and personality formation. Meanwhile, for spiritual factors, two elements were successfully formed: belief and confidence and the motivation to worship. This study provides vital information and implications that may guide the stakeholders to create various models, modules, and interventions to treat and prevent adolescents from engaging in social problems that affect their mental health.

Proportion of mental health problems in adolescents in Bangladesh

Adolescence is a crucial period for developing social and emotional habits important for mental well-being. Despite their relevance as a leading cause of disability in this age group, the mental health needs of adolescents are neglected. The aim of this study was to find out the proportion of adolescent mental health problems. It was a cross-sectional study which was conducted from October 2019 to September 2020 in Khwaja Yunus Ali Medical College, Sirajganj. Total 129 adolescents of both sexes aged between 13 to 19 years were evaluated through face to face interview using a semi structured questionnaire and Depression Anxiety Stress Scale 21 (DASS 21). The results showed that, 55.8% were male and 44.2% were female. It was found that, 42.6%, 55.8% and 44.2% had depression, anxiety and stress respectively. It was also found statistically significant of parent child relationship in mental health problems (P&lt;0.05). This study indicated that, mental health was a potential factor that could have an impact on the mental health status of adolescents. Further multi-centered prospective and population-based studies should be designed to find out the exact situation. Bang J Psychiatry 2022;36(1):1-5