Psychosocial Problems In Adolescents Research Articles

The mediating role of social support in the relationship between psychosocial problems and sleep patterns of adolescents with epilepsy

AimThis study was conducted to examine the mediating role of social support in the relationship between psychosocial problems of adolescents with epilepsy and their sleep patterns. MethodsThe data were collected with Adolescent Information Form, Strength and Difficulties Questionnaire, Sleep Disturbance Scale for Children and Multidimensional Scale of Perceived Social Support in this descriptive and correlational study. The mediating role of multidimensional social support that children with epilepsy received with the Process Macro program was examined in the relationship between their psychosocial problems and their sleep status. Process model 4 was used and analysis was made based on the Bootstrap method. ResultsAs a result of the analysis, it was found that the participants had been diagnosed with epilepsy for a mean of 6.0 ± 1.61 years and had a mean of 3.1 ± 2.48 seizures per week. It was found that the sleep problems experienced by adolescents with epilepsy affected their psychosocial health and this effect was at the level of 84 % (β = 0.933; p < 0.001). The effect of perceived social support on the dependent variable sleep disturbance in adolescents with epilepsy was found to be statistically significant (β = -0.540; p < 0.001). It was determined that the Psychosocial Health Status score of adolescents diagnosed with epilepsy explained 87 % of the change in sleep disturbance experienced with perceived social support (p < 0.001). The effect of social support perceived by adolescents with epilepsy on sleep disturbance was found to be statistically significant. Perceived social support has no effect on the psychosocial problems they experience. ConclusionsIt was found that social support was not a mediator in the relationship between psychosocial problems of adolescents with epilepsy and their sleep status.

Association between the starting age of non-parental Early Childhood Education and Care (ECEC), and psycho-social problems in adolescence in West and East Germany – a natural experiment using data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)

IntroductionThe study aimed to investigate the association between the start age of non-parental Early Childhood Education and Care (ECEC) and psycho-social problems in adolescence. The similarities and differences between West and East Germany were also investigated in a natural experiment.MethodsOur sample consisted of 1022 children (621 from West Germany, 401 from East Germany) aged 3–4 years at wave 2003–2006 that were followed up to wave 2014–2017 as adolescents (mean ± SD age = 14.4 ± 0.03 years) in the KiGGS study. The psycho-social problems were measured by the parent-reported Strengths and Difficulties Questionnaire (SDQ) at wave 2014–2017. Linear regression was used to explore the relationship between ECEC-start-age and psycho-social problems in adolescence in Germany, and stratified by West and East Germany.ResultsThose who started ECEC between 2 and 3 years old (reference) had the lowest scores of psycho-social problems in the whole Germany and in West Germany in adolescence. In comparison, those who started ECEC older than 3 years old had higher scores of internalizing psycho-social problems in both West Germany (with statistically significant results) and East Germany (with a relatively larger effect size but insignificant results). Those who started ECEC younger than 1 year old had statistically significant higher scores for externalizing psycho-social problems in West Germany, even though less children started ECEC younger than 1 in West Germany compared to East Germany. This significant association was not found in East Germany. Those who started ECEC between 1 and 2 years old tended to have higher scores of externalizing psycho-social problems in both West and East Germany.ConclusionThe results suggest that if children start ECEC older than 3 years or younger than 2 years, more attention needs to be given to internalizing or externalizing psycho-social problems respectively. The regional differences for children younger than 1 year old may suggest a selection effect in West Germany where only fewer parents bring babies to ECEC, while the regional similarities for children over 3 years old indicate the importance of providing access to ECEC for children over 3 years old.

Prevalence of psychosocial problems in adolescents of central India: a descriptive cross sectional study

Background: Adolescent’s psychosocial disorders exhibit as iceberg phenomenon and are one of the hidden health problems in population. Adolescents suffer from psychosocial problems at one or the other time during their development. Aim of study was to study the prevalence of psychosocial problems among adolescent. Methods: A community based descriptive cross-sectional study was conducted in urban field practice area of govt. medical college, Nagpur in Maharashtra. House to house survey was conducted and face to face interview was taken among 330 adolescents out of which 214 (64.84%) were male and 116 (35.16%) were female. Peadiatric Symptom Checklist Youth version (PSC-Y) was used as a tool to study the psychosocial problem. Results: In present study, overall prevalence of psychosocial problem was found to be 33.03%. Prevalence of psychosocial problem in male and female was 34.11% and 31.03% respectively. Psychosocial problems were more in age group of 14-16 years (39.69%) followed by 10-13 years 34 (31.48%) and 17-19 years age group 23 (25.27%). Conclusions: On basis of findings using PSC-Y, it is concluded that, a sizeable population (about one third of the adolescents) were suffered from psychosocial problem and the attention problem was most commonly found using PSC-Y subscales.

Psychosocial Problems on Adolescents with Thalassemia Major: A Systematic Scoping Review

Disease and treatment of thalassemia major that are carried out for life can cause physical and psychological problems in sufferers. Adolescents with thalassemia major will experience disturbances at a stage of development that is undergoing dynamic changes. Nurses, as health workers who provide holistic services, need to know what psychosocial problems may arise in adolescents with thalassemia major. This study aims to describe psychosocial problems in adolescents with thalassemia major. This study uses a scoping review design by searching English literature through the CINAHL, PubMed, and Scopus databases. The keywords used are psychosocial problems, thalassemia major, and adolescence. The criteria for the article in this study where the patient was a teenager with thalassemia, open access full text, and the time setting was the last 10 years (2013-2022). We found 9 articles discussing psychosocial problems in adolescents with thalassemia. Psychosocial problems that arise in the form of disturbances in several functions, namely physical, emotional, social, and school functions. Psychosocial disorders that occur in adolescents with thalassemia cause disturbances at the stage of adolescent development. Psychosocial problems that occur in adolescents with thalassemia include impaired physical, emotional, social, and school functions.&#x0D; Keywords: adolescence, psychosocial problems, thalassemia major

Relationship Social Media Activities with Adolescent Psychosocial at Junior High School 1 Damai City, Districts Damai

Introduction: Psychosocial problems in adolescents are also influenced by factors of internet activity (social media). Teens who actively play social media, namely 87% and 33.3% of those who have smartphones are teenagers who are addicted to smartphones and these teens show high levels of depression, anxiety, stress, and poor sleep quality. Objective: to know relationship social media activities with adolescent psychosocial at One Junior High School 1 Damai City Districts Damai. Method: The research design in this study was descriptive correlation using a cross-sectional approach. The study was conducted in February-April 2022. The statistical test used is Chi-Square if it is obtained t count (p-value) &lt;0.05, then the hypothesis Ha is accepted and Ho is rejected. Result and Discussion: Relationship of social media activity with psychosocial (pValue = 0.00). Activities using social media at Junior High School 1 Damai City Districts Damai are in the low category (59.2%). Psychosocial adolescent at Junior High School 1 Damai City Districts Damai in good category (35.9%). Conclusion: there is a relationship between social media activities with adolescent psychosocial at Junior High School 1 Damai City, Districts Damai.

Impact of dialectic behaviour therapy and assertiveness training on the mental health of socially stressed senior secondary students

Social stress resulting from substance abuse is a growing global concern. It is linked to mental health with psychosocial challenges faced by a large number of the populace in Nigeria. It is worrisome, especially among students in senior secondary schools in Port-Harcourt Metropolis. Thus, this research examined ‘Dialectic Behaviour Therapy and Assertiveness Training’ in managing psychosocial mental health problems of senior secondary school students who abuse substances in the Port-Harcourt metropolis. Tests before and after the study had a population of 9.650 students and employed quasi-experimental procedures. For the study, a 75-student sample from senior secondary school 2, comprised of 37 males and 38 females, was selected utilizing a multistage selection approach. Car, Relax, Alone, Forget, Family/Friends Trouble, Edinburg Mental well-being scale, and Social Phobia Inventory were the instruments utilized to collect the data. Findings revealed significant differences in the psychosocial problems of adolescents in senior secondary schools because of the interventions, however, dialectic behaviour therapy made more impact in the reduction of adolescents’ social stress though both treatments had a significant impact. Keywords: Assertiveness training, dialectic behaviour therapy, mental health, social stress, substance abuse

Impact of dialectic behavior therapy and assertiveness training on mental health of socially stressed senior secondary students

Social stress from substance abuse is common and worrisome, especially among adolescents. Therefore, this study examined “Dialectical Behavior Therapy and Assertiveness Training” in the management of mental health problems of high school seniors who abuse substances. In the resADDREearch, quasi-experimental pre-test and post-test design were used. The research was conducted with 75 students using the multi-stage sampling method. Tools used to collect data are Car, Relax, Alone, Forget, Family/Friend Issue, Warwick Edinburgh Mental Well-Being Scale, and Social Phobia Inventory. Two research questions were raised, and two research hypotheses were tested at the 0.05 significance level. The findings revealed that there was a significant difference in the psychosocial problems of adolescents in high school seniors as a result of the interventions, but dialectical behavioral Therapy had a greater effect in reducing adolescents’ social stress, although both treatments had significant effects. Based on the findings, it was recommended that assertiveness education be added to the secondary school curriculum to reduce the incidence of substance abuse.&#x0D; Keywords: Mental health, substance abuse, dialectic behavior therapy, assertiveness training.

Psychosocial Problems in Adolescents with Sickle Cell Anaemia on Hydroxyurea in Jos, North Central Nigeria

Background: A lot of adolescents with sickle cell anaemia constantly face unpleasant ill health conditions such as chronic pain as well as feelings of frustration over their general well-being and psychological adjustment which may distort medical care and spell bad prognosis for their condition. This study therefore assessed the psychosocial problems of adolescents with sickle cell anaemia who are on hydroxyurea in Jos, North central Nigeria. Method: This study was a comparative cross-sectional study among adolescents with Sickle Cell Anaemia (SCA) who were on hydroxyurea and those not on hydroxyurea in Jos University Teaching Hospital, Jos, North Central Nigeria. Eighty-eight participants who were from ages of 11- 17 years were selected for the study between February and August, 2020. Data were collected with the use of questionnaire. Data analysis was conducted using Statistical Package for Social Sciences version 18 (SPSS Inc., Chicago, IL, USA). Test for association was done using Fisher’s exact test. Results: The result of the study showed that there was no difference between those on hydroxyurea and those not on hydroxyurea. The study equally showed that there was no statistically significant difference (p&gt;0.05) in psychosocial life of adolescent SCA patients who used hydroxyurea and those who did not use hydroxyurea. Conclusion: Hydroxyurea medication in adolescents with sickle cell anaemia for a year and above did not impact on their psychosocial life.

Psycho-social problems of adolescents with sickle-cell anaemia in Ekiti State, Nigeria.

Sickle-cell disease comprises a group of genetic disorders characterized by the inheritance of sickle haemoglobin from both parents. Sickle-cell disease carries a huge psycho-social burden which has impacts on the physical, psychological, social and occupational well-being as well as levels of independence on adolescents. To investigate the psycho-social problems of adolescents with sickle-cell anaemia in Ekiti State. The study also examined whether the variables of age and educational level would influence the psycho-social problems of adolescents with sickle-cell anaemia in Ekiti State. Descriptive survey design was adopted for the study. Purposive sampling technique was adopted to draw a total of 121 respondents. A questionnaire was used to collect data for the study. Mean and rank order was used to answer the research question while Analysis of Variance was used to test the hypotheses at 0.05 level of significance. Findings revealed that psycho-social problems of adolescents with sickle-cell anaemia are limited in the choice of career, find it difficult to get suitable partner in marriage and SCD adolescents usually manifest emotional upset, misbehaviour, and have learning problems. Findings also revealed that there were significant differences in the psycho-social problems of adolescents with sickle-cell anaemia based on age and educational level. Majority of the respondents attested to the psycho-social problems facing adolescents with sickle-cell anaemia. Based on the findings of the study, it was recommended that social workers should be employed in health sectors; government should offered standard health care for all adolescents with sickle cell disease.

A CROSS-SECTIONAL STUDY ON COMMON BEHAVIORAL PROBLEMS AMONG THE UNDERPRIVILEGED ADOLESCENTS IN A SCHOOL OF KOLKATA.

Adolescence is characterized by conicts of values, emotional stress and readiness to extreme attitudes, which invariably leads to several psychosocial problems of adolescents. During adolescence, the frequency and severity of violent interactions increase. Worldwide, the prevalence of clinically signicant psychiatric disorder in children is at least 7%. This rate rises in socially disadvantaged and densely populated urban areas. It also increases by 3%-4% after puberty. Substance abuse is a common trigger of behavioral problems and often requires specic therapy. Behavioral problems may be the rst sign of depression or other mental health disorders. With this background this study is conducted to nd out different behavioral and psychological problems of underprivileged adolescents studying in a school of Kolkata and their background information as well. This observational &amp; descriptive epidemiological study was cross-sectional in design, was conducted from December 2019 to February, 2020. The School has at present 500 students from class Ι to X. In each class there are 50 students. The school has provisional afliation from ICSE Board. 20 students were selected from each class by Stratied Random Sampling method by using random number table from the list of the students of class VI to X. A predesigned, pretested, self-administered questionnaire was used for data collection. The questionnaire was translated to two local languages i.e. Bengali &amp; Hindi. Most common behavioral problems were lying (88%), phobia (86%). Anxiety (80%), followed by cruelty and destruction (44%), school failures (36%), depression (28%), stealing (20%), masturbation (10%), addiction (8%). Common problems among male students were Anxiety, Phobia, Lying, Cruelty, School failure. Among female students, Phobia, Depression, Anxiety &amp; Lying were common behavioural problems. 62 adolescents told that they had phobia. Among them 62.9% adolescent had phobia to specic object. 32.26% had social phobia and 4.84% had school phobia. Further longitudinal studies should be planned to nd out temporal association of these behavioral and psychological problems among this study group.

PARENTAL EXPRESSED EMOTION (EE) PREDICTS PSYCHOSOCIAL PROBLEMS IN ADOLESCENTS: A LITERATURE REVIEW

Background: Psychosocial problems in adolescents are often associated with difficulty in achieving their developmental tasks sense of identity that lead them to the role of confusion. The parents play an important role in assiting and supporting the adolescents to accomplish their developmental task during this age but sometimes the emotions, attitudes or behaviors shown by parents (Expressed Emotion/ EE) were actually considered to be factors that influence the psychosocial problems in adolescents. Aim: To describe the correlation between EE in parents and psychosocial problems in adolescents. Methods: A literature review was conducted to collect English-language articles form online database such as Proquest, PubMed, Sagepub, Science Direct and Taylor &amp; Francis about the correlation between EE and psychosocial problems in adolescents from 1985 to 2020. Results: Adolescents with psychosocial problems tend to have parents with high EE and Criticism apparently became the most influential aspect in affecting psychosocial problems in Adolescents Conclusion: It is important to strengthen education and therapy for parents to decrease critical parenting style as an effort to promote adolescent mental health.&#x0D;

Accumulated unhealthy behaviors and psychosocial problems in adolescence are associated with labor market exclusion in early adulthood \u2013 a northern Finland birth cohort 1986 study

BackgroundThe relevance of health-related behaviors to exclusion from the labor market in early adulthood remains poorly studied in relation to the magnitude of the problem. We explored whether adolescents’ accumulated unhealthy behaviors and psychosocial problems are associated with later labor market exclusion, and whether multisite musculoskeletal pain (MMSP) impacts these relations.MethodsWe gathered questionnaire data on unhealthy behaviors and psychosocial problems and MMSP among adolescents aged 15 to 16 belonging to the Northern Finland Birth Cohort 1986. The findings were combined with registry data on unemployment, employment and permanent work disability during a five-year follow-up between the ages of 25 and 29 (n = 6692). In the statistical modeling we used education, family leave and socioeconomic status of childhood family as potential confounders, as well as latent class and logistic regression analyses.ResultsThe Externalizing behavior cluster associated with over one year of unemployment (RR 1.64, CI 1.25–2.14) and permanent work disability (OR 2.49, CI 1.07–5.78) in the follow-up among the men. The Sedentary cluster also associated with over one year (RR 1.41, CI 1.13–1.75) and under one year of unemployment (RR 1.25, CI 1.02–1.52) and no employment days (RR 1.93, CI 1.26–2.95) among the men. Obese male participants were at risk of over one year of unemployment (RR 1.50, CI 1.08–2.09) and no employment days (RR 1.93, CI 1.07–3.50). Among the women, the Multiple risk behavior cluster related significantly to over one year of unemployment (RR 1.77, CI 1.37–2.28). MMSP had no influence on the associations.ConclusionsUnhealthy behavior patterns and psychosocial problems in adolescence have long-term consequences for exclusion from the labor market in early adulthood, especially among men. Simultaneously supporting psychological well-being and healthy behaviors in adolescence may reduce labor market inclusion difficulties in the early phase of working life.

Family-related factors and its impact on psychosocial health of school-going adolescents of Urban Rishikesh, Uttarakhand

Background: Psychosocial problems occur in a wide variety of settings, and they often have a negative impact on adolescents' mental health. The family environment influences the psychosocial development of adolescents in this transitional phase. This study was conducted to find the association between psychosocial problems and the family environment. Materials and Methods: We conducted a cross-sectional study for 6 months among school-going adolescents of urban Rishikesh, Uttarakhand. In this study, a self-administered questionnaire consisting of Youth-Pediatric Symptom Checklist and family-related factors was given to the students. The data were compiled and analyzed using appropriate statistical analysis. Results: A total of 400 adolescent students participated in the study. The prevalence of psychosocial problems was 40.7%. Psychosocial problems were significantly associated with family-related factors which were further divided into three subgroups. First, the family environment which includes problems in the family (61.8%), parents understanding each other (61.8%), and participants feeling happy at home (34.2%). The second subgroup was parent–child relationships such as parents pay attention (27.9%), understanding parents (30.3%), and parents unhappy with participant's academic performance (63.6%). The third subgroup was parenting style such as parents allow children to take their own decisions (23.4%), parents comparing their child with other children (63.6%), parents are strict (63.1%), getting pocket money (35.7%), and interfering parents (64.3%). There was no significant association found between getting pocket money and psychosocial problems. Conclusion: Family-related factors have a significant impact on adolescents' psychosocial health; thus, targeted interventions are required. It is of paramount importance to educate parents, community stakeholders, and schools regarding psychosocial problems in adolescents.

Psychotic experiences and trauma predict persistence of psychosocial problems in adolescence.

Psychosocial problems during adolescence are heterogenic, rather common, and unstable. At the same time, they are associated with an elevated risk of developing psychiatric disorders later in life. We aimed to describe the trajectories of psychosocial problems during adolescence and examine potential markers of persistence as compared to remission of these problems. At baseline, 1841 adolescents (51.4% female) were included. Of these adolescents, 1512 (mean age = 12.6 [range 11-14years]; 52.8% female) completed the first and second self-report questionnaires on psychosocial problems (measured with the Strengths and Difficulties Questionnaire), psychotic experiences, trauma, self-esteem and somatic symptoms at two time points over a 1-year period. Regression analyses were used to examine the association between potential predictors and the trajectory of psychosocial problems (remitting versus persistent). Four trajectories were distinguished: 75.6% of the sample showed no problems (the 'none' trajectory), 11.9% were in a 'remitting' trajectory, 9.7% were in an 'incident' trajectory and 2.8% were in the 'persistent' trajectory. Hallucinatory experiences and trauma at baseline were significantly associated with persistence of psychosocial problems compared to those with remitting psychosocial problems. Low rather than high self-esteem was associated with lower risk for persistent problems. Risk of persistence of psychosocial problems increased with accumulation of predictors. Psychotic, especially hallucinatory, experiences and trauma predict persistence of psychosocial problems in adolescents. This underlines the need to assess psychotic experiences and trauma in mental health screening programs.

Psycho-Social Problems of Post- Graduate Students of College of Agriculture, UAS, Raichur

Increasing independence from adult controls, rapidly occurring physical and psychological changes, exploration of social issues and concerns, increased focus on activities with a peer group and establishment of a basic self identity contribute to adolescent maladjustment. Factors for adolescent maladjustment include economic instability, parental discord, inadequacy of school offerings, lack of understanding of adolescent psychology on the part of parents and school faculties, and inadequate recreational facilities. This study on psycho-social problems of adolescents with 90 post graduate students will help the parents, teachers, teacher educators and even the public to be familiar with the problems of adolescents. Findings reveal that adolescents at higher level face more problems from educational and emotional aspects.

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

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

Perceived parental rejection mediates the effects of previous maltreatment on emotional and behavioural outcomes in Chinese adolescents whereas mental illness has no moderating effect.

ObjectiveThis study assessed the mediating role of perceived parental rejection in the relationship between childhood maltreatment experience and behavioural problems in Chinese adolescents.MethodsA total of 2484 adolescents (1305 males and 1179 females; aged 12–16 years) from Hunan Province, China, participated in the study. Behavioural problems, parental rejection scores and child abuse experiences were evaluated by the Child Behavior Checklist (parental version), the Memories of Parental Rearing Behavior Scale and the Childhood Trauma Questionnaire, separately. Mediating effects were examined by structural equation modelling using Amos 20 software.ResultsThe study found that perceived maternal rejection partially mediated the association between abuse and internalising behaviours in the male cohort, whereas perceived father’s rejection partially mediated this association in the female cohort. However, mental illness had no moderating effect on these relationships.ConclusionThese results are consistent with the literature on maltreatment and parent-child relationships and provide empirical support for the view that emotional and behavioural problems related to perceived parental rejection underlie the development of psychosocial problems in adolescents.

Effects of urinary incontinence on psychosocial outcomes in adolescence

To examine whether daytime wetting and bedwetting urinary incontinence (UI) in childhood and adolescence are associated with psychosocial problems in adolescence. We used data from the Avon Longitudinal Study of Parents and Children to examine the association between trajectories of UI from 4 to 9 years and self-reported psychosocial problems in adolescence (13–14 years) including depressive symptoms, peer victimisation, poor self-image and school experiences (negative perception of school and teachers, problems with peer relationships). Sample sizes ranged from 5162 (perception of teachers) to 5887 (self-image). We also examined associations between self-reported UI at 14 years and psychosocial problems. Relative to normative development, adolescents who experienced delayed development of bladder control had poorer self-image [standardised mean difference = 0.18 (95% CI 0.04, 0.32)], more negative perceptions of school [0.18 (0.02, 0.34)] and more problems with peer relationships at school [0.25 (0.10, 0.40)]. Persistent wetting (bedwetting with daytime wetting) in childhood was associated with increased problems with peer relationships in adolescence [0.19 (0.03, 0.34)]. The strongest associations between adolescent UI and psychosocial problems were found for daytime wetting (reference = no UI at 14 years): depressive symptoms [OR = 3.04 (95% CI 1.91–4.84)], peer victimisation [2.14 (1.48–3.10)], poor self-image (t = −8.49, p < 0.001) and problems with peer relationships (t = −4.69, p < 0.001). Children with delayed development of bladder control and persistent wetting have increased psychosocial problems in adolescence. Adolescents with UI reported a range of psychosocial problems and clinicians should be aware that they might require support from psychological services.

Less reduction of psychosocial problems among adolescents with unmet communication needs

Patient-professional communication has been suggested to be a major determinant of treatment outcomes in psychosocial care for children and adolescents. However, the mechanisms involved are largely unknown and no longitudinal studies have been performed. Our aim was, therefore, to assess over the course of 1 year, the impact of patient-centered communication on psychosocial problems of adolescents in psychosocial care, including the routes mediating this impact. We obtained data on 315 adolescents, aged 12–18 years, enrolled in child and adolescent social or mental health care. We assessed patient-centered communication by comparing the needs and experiences of adolescents with regard to three aspects of communication: affective quality, information provision, and shared decision-making. Changes in psychosocial problems comprised those reported by adolescents and their parents between baseline and 1 year thereafter. Potential mediators were treatment adherence, improvement of understanding, and improvement in self-confidence. We found a relationship between unmet needs for affective quality, information provision, and shared decision-making and less reduction of psychosocial problems. The association between the unmet need to share in decision-making and less reduction of psychosocial problems were partially mediated by less improvement in self-confidence (30 %). We found no mediators regarding affective quality and information provision. Our findings confirm that patient-centered communication is a major determinant of treatment outcomes in psychosocial care for adolescents. Professionals should be aware that tailoring their communication to individual patients’ needs is vital to the effectiveness of psychosocial care.

Psychosocial Problems Syndemically Increase Adolescent Substance Use: Findings From a Cross-sectional Survey of 82,812 Chinese Adolescents.

A growing body of studies have indicated the associations between substance use and psychosocial problems in adolescents. However, few of them have examined whether these psychosocial problems form a syndemic, which means the co-occurrence of psychosocial problems accompanied by additional effects on substance use.We conducted a cross-sectional survey with 82,812 Chinese adolescents who were selected using a multistage random procedure. Bivariate associations were estimated between selected syndemic indicators and adolescent substance use. Multivariate logistic regression was used to estimate the association between the syndemic indicator count score (the count of syndemic indicators) and adolescent substance use. In addition, cluster analysis was used to partition participants reporting at least one of syndemic indicators to assess associations between resolved cluster memberships and adolescent substance use.All selected syndemic indicators were associated with each other and with adolescent substance use. As the number of syndemic indicators increases, stronger associations with substance use were found in our analysis: the range of adjusted OR was from 1.57 (95% CI: 1.38–1.79) for 1 syndemic indicator to 9.45 (95% CI: 7.60–11.76) for 5 or 6 syndemic indicators. There was no effect modification of gender on these additive associations. The multivariate logistic regression indicated that the cluster membership of nonlow SES academic failures has the highest odds of using substance (OR = 2.26, 95% CI: 2.12–2.41), compared to students reporting none syndemic indicators.Our findings support the syndemic hypothesis that adolescents bearing multiple psychosocial problems experience additive risks of using substance. Our findings support that a comprehensive approach to substance use prevention in adolescents would necessitate the involvement of a variety of providers.