Subgroup Of Adolescents Research Articles

Exploring the association between low birthweight and adolescent mental health in the United Kingdom

Abstract Low birthweight (LBW) is associated with a range of medical conditions including behavioural and emotional problems over the life course. This study aimed to explore the association between LBW and internalising and externalising mental health problems (MHP) in adolescents born in the United Kingdom between 2000 and 2002. Data were analysed for 10,485, 9,228, and 8,402 Millennium Cohort Study participants at ages 11, 14 and 17, respectively. Internalising and externalising MHP were measured using the Strengths and Difficulties Questionnaire (SDQ). LBW was subcategorised by size for gestational age and prematurity. Crude and adjusted associations between LBW subgroup and internalising and externalising MHP were estimated using binary logistic regression. Internalising MHP were more prevalent in LBW than NBW participants at ages 11 (14.2% vs 10.3%, p < 0.001), 14 (19.4% vs 13.7%, p < 0.001), and 17 (parent-report: 20.3% vs 14.8%, p < 0.001; self-report: 25.7% vs 20.1%, p < 0.001), respectively. Externalising MHP were more common amongst LBW participants at ages 11 (9.4% vs 7.3%, p = 0.02) and 14 (9.0% vs 6.6%, p = 0.01). Compared with NBW peers, the odds of internalising (males: aOR 2.18, 95% CI 1.21-3.73, p = 0.007; females: aOR 2.17, 95% CI 1.22-3.66, p = 0.005) and externalising MHP (males: aOR 2.01, 95% CI 1.05-3.60, p = 0.014; females: aOR 2.58, 95% CI 1.14-5.24, p = 0.016) were significantly increased in male and female premature small for gestational age (SGA) participants at age 11. Externalising MHP were significantly increased amongst premature SGA females aged 14 (aOR: 2.53, 95% CI 1.01-5.66, p = 0.016). Internalising MHP were significantly increased in premature SGA females at age 17 based on parent (aOR: 2.41, 95% CI 1.38-4.22, p = 0.005) and self-report (aOR: 1.95, 95% CI 1.14-3.31, p = 0.014). Amongst LBW individuals, premature SGA females have the greatest risk of internalising and externalising MHP during adolescence, thus identifying an important target group for intervention. Key messages • This study provides evidence for the longitudinal association between low birth weight and mental health in adolescents born in the United Kingdom in the 21st century. • Stratification of low birth weight individuals by size for gestational age and prematurity enabled the identification of a subgroup of adolescents for mental health promotion.

Unique and interactive roles of economic stress and discrimination on heterogeneous development among Chinese American adolescents: An 8-year longitudinal study.

Chinese American youth as a group are often labeled as "model minorities." Yet, this label ignores the vast heterogeneity within Chinese Americans and implies that they are immune to environmental stressors. Using an 8-year longitudinal study of 444 (54% female; initial Mage = 13-year-old) Chinese American adolescents, we identified two (well- vs. poorly adjusted) concurrent and three (stably well-adjusted, improved, and risk) latent transition profiles from early adolescence to emerging adulthood based on six indicators of academic, behavioral, and socioemotional functioning. Multilevel modeling revealed higher levels of family economic stress or discrimination independently associated with higher likelihood to be in the subgroup of adolescents with poorly adjusted patterns across development. Within an individual, Chinese American adolescents were more likely to have worse adjustment patterns in the year when they experienced higher economic stress or discrimination relative to other study years, suggesting that their adjustment are sensitive to the fluctuation of stress level during development. Longitudinally, those who experienced higher family economic stress or discrimination at early adolescence were more likely to become at risk when they reached adulthood. Higher discrimination predicted the likelihood to be in the improved groups but only among adolescents with low (but not high) economic stress, suggesting that the influence of discrimination may vary by family socioeconomic status. Findings (a) challenge the model minorities assumption, (b) highlight the importance of capturing multiple ecological contexts associated with heterogeneous development among Chinese American adolescents, and (c) provide longitudinal evidence to social policies aiming to reduce wealth disparities and anti-Asian racism. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The experience of adolescence process among French teenager pregnancies: a mixed-methods study

ABSTRACT Purpose Teenage pregnancy remains a significant global public health concern worldwide. However, it presents a complex phenomenon in developed countries, carrying potential short- and long-term consequences for both mothers and children. Methods This mixed method study used data from the French cross-sectional study “Portraits of adolescents”, which included 6000 girls aged between 13 and 17 years. The quantitative approach involved comparisons between a subgroup with an history of pregnancy and their peers, examining their lived-experience and mental health. The qualitative approach investigated the question “What does being a teenager mean for you?” specifically for the girls who reported an history of pregnancy. Results Teenage pregnancies presented elevated rates of mental health disorders, including dark thoughts, depression, self-harm, participating in dangerous games, attempting suicide and increased use of psychoactive substances. With limited support, in comparison to their peers. The qualitative approach revealed three major themes: “being in action”, “a way of feeling”, and “quality of relationship”. Conclusion This vulnerable subgroup of adolescents suggests the need for a coordinated multidisciplinary healthcare approach, given their limited parental and friend support, with a high risk of experiencing poor mental health. Additionally, these findings portray a “silent sufferer” population characterized by difficulties recognizing or managing emotions due to difficulties in expressing their emotional distress.

Attachment Problems and Mentalizing Capacity Relate to Parent-Child Informant Discrepancies in Female Adolescents with Borderline Personality Disorder.

Parent-child informant discrepancies on psychopathology provide important knowledge on the parent-child relationship and the child's mental health, but mechanisms underlying parent-child informant discrepancies are largely unknown. Therefore, we investigated the relationship between attachment problems and mentalizing capacity and parent-child informant discrepancies on borderline personality disorder (BPD) severity, internalizing, and externalizing pathology in a clinical sample of 91 adolescent girls with BPD and their parents. Results showed that more attachment problems to parents and peers were related to adolescents reporting more severe BPD than parents. Adolescents who described more internalizing symptoms relative to parents, reported more parental attachment problems, but enhanced peer attachment, suggesting those adolescents who do not feel recognized by their parents might turn to their friends. When parents rated adolescents higher on externalizing behaviors, the adolescent reported more attachment problems to parents and lower mentalizing capacity, indicating that this sub-group of adolescents may reflect less about how their behavior affects others.

Amygdala volumes and associations with socio-emotional competencies in preterm youth: cross-sectional and longitudinal data.

Socio-emotional difficulties often result from very preterm (VPT) birth. The amygdala's developmental trajectory, including its nuclei, has been recognized as a significant factor in observed difficulties. This study aims to assess the relationship between amygdala volume and socio-emotional competencies in VPT children and adolescents. Socio-emotional competencies were assessed, and amygdala volumes, including subnuclei, were extracted automatically from structural scans in a cross-sectional cohort of VPT (n = 75) and full-term (FT, n = 41) aged 6-14 years. Group differences in amygdala volumes were assessed using ANCOVA, and associations with socio-emotional competencies were studied using partial least squares correlation (PLSC). In a VPT subgroup, additional longitudinal data with amygdala volumes at term-equivalent age (TEA) were manually extracted, growth rates calculated, and associations with school-age socio-emotional competencies investigated using PLSC. Using cross-sectional data at school-age, amygdala volumes displayed comparable developmental patterns between the VPT and the FT groups. Greater volumes were associated with more emotional regulation difficulties in VPT and lower affect recognition competencies in FT. In the longitudinal VPT subgroup, no significant associations were found between amygdala volume trajectory and socio-emotional competencies. Although our findings suggest typical amygdala development after VPT birth, further research is necessary to elucidate the developmental trajectory of amygdala and the role of resilience factors. In our cohort, amygdala volumes, including subnuclei, displayed comparable developmental trajectories between the very preterm and the full-term groups. Higher amygdala volumes at school-age were associated with higher emotional regulation difficulties in the very-preterm born group, and with lower affect recognition abilities in full-term born children and adolescents. In a subgroup of very-preterm children and adolescents followed from birth to school-age, no significant associations were found between amygdala volumes at term-equivalent age and socio-emotional competencies at school-age.

Bidirectional Within-Family Effects of Restrictive Mediation Practices and Adolescents’ Problematic Social Media Use

Much remains unknown about whether restrictive mediation is an effective parenting strategy to prevent or reduce problematic social media use among adolescents. Therefore, this study examined bidirectional within-family effects between two restrictive mediation practices (rule-setting and reactive restrictions) and problematic social media use using random-intercept cross-lagged panel modeling. Three-wave survey data collected among Dutch adolescents (T1: N = 1928, Mage = 13.31 years, SD = 0.91, 43.3% girl) with a 1 year-interval were used. Results showed that within-family changes in problematic social media use symptoms predicted subsequent within-family changes in perceived parental restrictive mediation. More specifically, an increase in symptoms predicted a decrease in rule-setting and an increase in reactive restrictions 1 year later. Within-family changes in perceived parental restrictive mediation practices did not predict within-family changes in problematic social media use symptoms, suggesting that the relation is unidirectional. However, concluding that limiting adolescents’ Internet use is ineffective to prevent problematic social media use would be premature. Future research should investigate whether it may be an effective parenting strategy for a certain subgroup of adolescents or under certain circumstances.

Change in symptoms of depression and eating disorders in adolescents with obesity participating in a clinical trial

Depression and eating disorder (ED) risk are heightened during adolescence(1) and both were exacerbated during COVID-19 lockdowns. This analysis reports changes in self-reported symptoms of depression and eating disorders throughout the Fast Track to Health trial. Fast Track to Health was a 52-week multi-site randomised-controlled trial, conducted 2018-2023, comparing intermittent (IER) and continuous energy restriction (CER) in adolescents with obesity and ≥1 associated comorbidity(2). The Centre for Epidemiologic Studies Depression Scale-revised 10-item version for adolescents (CESDR) was used to assess symptoms of depression (no symptoms, sub-threshold, or possible, probable, major depressive episode). Eating Disorder Examination Questionnaire (EDE-Q) was used to assess ED risk; defined as global score ≥2.7, ≥2 episodes of binge eating with/without loss of control, or ≥1 episode of purging within the last 28-days. The Binge Eating Scale (BES) assessed severity of binge eating (no binge eating, mild/moderate, severe). Adolescents were monitored for disordered eating during dietetic consults. Linear mixed models, retaining all data consistent with intention-to-treat analysis, were used to estimate the change in outcomes from baseline to week-52. Descriptive statistics were used to describe the number of participants meeting screening criteria at baseline and week-52. One hundred and forty one adolescents were enrolled and 97 completed the trial, with median (IQR) EDE-Q score 2.28 (1.43 to 3.14), CESDR 9.00 (4.0 to 14.5) and BES 11.0 (5.0 to 17.0) at baseline. EDE-Q (change in estimated marginal means [SE], IER −0.63 [0.18], CER −0.56 [0.17]) and CESDR (IER −2.70 [1.15], CER −3.87 [1.07]) scores reduced between baseline and week-52 in both groups (p<0.05) with no difference between groups. There was a between group difference (p = 0.019) in change in BES. The IER group had a reduction between baseline and week-52 (−3.72 [1.27]) and the CER group had no change. At baseline, 31 (22%) adolescents were classified as having a possible/probable/major depressive episode, 110 (78%) met ≥1 ED criteria and 28 (21%) as mild/moderate or severe binge eating, reducing to 8 (9%), 56 (61%) and 15 (16%) respectively at week-52. A small sub-group of adolescents required additional support for disordered eating. Overall, treatment-seeking adolescents with obesity have symptoms of depression and ED. Although symptoms reduce for most, some required additional support. Screening and monitoring for depression and ED are important to ensure early intervention.

Association between anxiety and elevated blood pressure in adolescent patients: a single-center cross-sectional study.

Although anxiety is known to be associated with elevated blood pressure and hypertension in adults, this has not been studied in children. The aim of this study was to determine the association between anxiety and elevated blood pressures in adolescents. Adolescents, aged 12-18 years old, referred to the nephrology clinic were eligible to participate. Elevated blood pressure was defined as either SBP or DBP measurement above the 95th percentile for age, height, and sex. Participants were evaluated for anxiety using the validated Screen for Child Anxiety Related Disorders questionnaire filled independently by the child (SCARED-C) and parent (SCARED-P) evaluating the child. Two hundred adolescents participated in this study. Thirty-one (53%) of SCARED-P-positive participants were found to have elevated blood pressure compared with 27 (19%) of SCARED-P negative, P 0.03. Twenty-five (43%) of SCARED-P positive had elevated DBP compared with 31 (28%) of SCARED-P negative ( P 0.003). In SCARED-P positive, mean DBP (78.4 ± 9.9) was higher compared with SCARED-P negative (74.9 ± 9.2) ( P 0.03). In a subgroup of adolescents (№ 130) not treated with blood pressure medications mean DBP was higher in both SCARED-P (79.0 ± 10.1) and SCARED-C (77.1 ± 10.4) positive groups compared with SCARED-P (73.6 ± 9.3) and SCARED-C (73 ± 8.9) negative, respectively. Our study demonstrates an association between anxiety and elevated DBP in adolescent children. Screening adolescents for anxiety should be a part of the routine evaluation of adolescent children.

Changes of adolescent sleep patterns during the COVID-19 pandemic.

The COVID-19 pandemic has raised numerous concerns regarding its effects on individuals' health and lifestyle. We aim to analyze potential changes in adolescent sleep patterns from before and during the pandemic and identify specific predictors of changes. A subgroup of adolescents from a population-based birth cohort from Pelotas, Brazil, was assessed pre-pandemic (T1, November-2019 to March-2020) and peri-pandemic (T2, August-2021 to December-2021) in in-person interviews (n = 1,949). Sleep parameters, including sleep duration and latency time on workdays and free days, as well as social jetlag (SJL), were assessed using the Munich ChronoType Questionnaire (MCTQ). Socio-demographic, pre-pandemic, and pandemic-related predictors were analyzed. Changes in sleep parameters from T1 to T2 were estimated by multivariate latent change score modeling. The latent change factor shows a significant mean increase in workday sleep duration (M = 0.334, p < 0.001), workday sleep latency (M = 0.029, p = 0.002), and free day sleep latency (M = 0.021, p = 0.034), and a decreased in SJL (M = -0.758, p < 0.001) during the pandemic. Female adolescents presented higher increases in workday sleep duration. Adolescents who adopted a stricter social distancing level during the pandemic presented greater increases in workday sleep duration and smaller reductions in SJL. Self-evaluated insomnia during the pandemic predicted lower increases in workday and free day sleep duration and higher increases in workday and free day sleep latency. The COVID-19 outbreak brought certain advantages regarding increased sleep duration and reduced SJL. However, the observed increase in sleep latency and the influence of self-reported insomnia could be related to psychological distress inherent to the pandemic.

Antipsychotic effects on anthropometric outcomes in anorexia nervosa: a retrospective chart review of hospitalized children and adolescents

BackgroundOff-label antipsychotic use is not uncommon in youth with anorexia nervosa (AN), aiming to enhance suboptimal weight restoration, yet its efficacy remains debated, especially in youth.MethodsRetrospective chart review of consecutively admitted inpatients (ages 8–18 years) with restricting/binge-purge AN, comparing youth with versus without antipsychotic treatment regarding baseline factors, treatment, and anthropometric outcome characteristics including all patients and matched subgroups. Matched subsamples were also compared regarding faster versus slower weight change (median split). Furthermore, within-subject analyses compared weight gain trajectories before versus after antipsychotic use in antipsychotic-treated youth. These results were then compared in a pre-/post design with the matched control group without antipsychotic treatment, using the mean duration until antipsychotic use in the antipsychotic-treated group as the dividing timeline, controlling for a potential order effect, in that later rather than earlier antipsychotic treatment for AN may be more successful.ResultsOf 294 youth with AN (median age = 15.2 (interquartile range = 14.0, 16.6) years, females = 96.6%, restricting subtype = 81.0%, hospitalization duration = 98.2 ± 43.2 days), 44 (15.0%) underwent 52 antipsychotic trials (olanzapine = 63.5%). In multivariable analyses, antipsychotic use was independently associated with younger age, childhood physical abuse history, comorbid borderline personality traits, and lower pre-antipsychotic weight gain (p < 0.0001). In unmatched groups, antipsychotic-treated versus non-treated youth had significantly lower discharge anthropometric parameters, longer inpatient treatment, and lower weight change/week (p < 0.001–p = 0.005), without significant differences between olanzapine and non-olanzapine antipsychotics (p = 0.27–0.44). Non-significant antipsychotic effects on weight outcomes were confirmed in (1) matched subgroups of antipsychotic-treated versus non-treated youth (n = 43 each), (2) youth with faster versus slower weight gain (n = 21 vs. n = 22), and (3) antipsychotic-treated youth when comparing weight change before versus after antipsychotic use (n = 31). Moreover, in antipsychotic-treated youth, weight change/week remained significantly lower versus matched non-antipsychotic-treated youth (n = 31) both before (p = 0.053) and after (p = 0.006) the median time (5 weeks) until antipsychotic use.ConclusionsIn this naturalistic study, clinician's antipsychotic choice, given to a more severely ill subgroup of adolescents with AN, did not significantly improve overall worse weight change trajectories during inpatient treatment, even in matched subgroups. Randomized trials in individuals reflecting real-world samples are needed to evaluate the utility of antipsychotic treatment in youth with AN.

Out-of-home interventions for adolescents who were treated according to the Open Dialogue model for mental health care

BackgroundThe Open Dialogue approach (OD) emphasizes community-based psychiatric treatment for adolescents, but its success in achieving this is poorly documented. ObjectiveTo analyse out-of-home intervention usage in a national sample of adolescent psychiatric patients and determine if OD is linked to increased time until out-of-home intervention. Participants and settingThe register-based cohort study included all adolescents aged 13–20 who received psychiatric treatment in Finland between 2003 and 2008. The research group (n = 780) included adolescents whose treatment was initiated in the Western Lapland catchment area, where OD covered the entire psychiatric service. The comparison group (n = 44,088) included the rest of Finland. National register data encompassed the period from treatment onset until the end of the 10-year follow-up or death. The primary outcomes of interest were the times to the first and second out-of-home intervention, including foster care, supportive housing, and hospitalization. The secondary outcomes included the clinical/demographic characteristics of adolescents treated out-of-home. MethodsThe hypothesis was tested via an inverse probability of treatment–weighted Cox hazard model, plus within- and between-group comparisons to analyse the secondary outcome. ResultsOD was associated with increased time to the first (adjusted hazard ratio [aHR]: 0.61, 95%CI: 0.52–0.72) and second (aHR: 0.75, 95%CI: 0.58–0.96) out-of-home interventions. In both service types, there was a subgroup of adolescents with repeated out-of-home interventions, who also demonstrated poorer long-term outcomes. ConclusionOD-based psychiatric services for adolescents are associated with fewer out-of-home interventions. The clinical significance of the findings warrants further research.

Heterogeneity in the trajectories of psychological distress among late adolescents during the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has constrained opportunities in social, educational and professional domains, leading to developmental challenges for adolescents initiating their transition to adulthood. Meta-analysis indicated that there was a small increase in psychological distress during the first year of the COVID-19 pandemic. However, significant heterogeneity in the psychological response to the COVID-19 pandemic was noted. Developmental antecedents as well as social processes may account for such heterogeneity. The goal of this study was to characterize trajectories of psychological distress in late adolescence during the COVID-19 pandemic. 5014 late adolescents born between 2000 and 2002 from the UK Millennium Cohort Study completed online self-reported assessments at three occasions during the first year of the COVID-19 pandemic (May 2020, September/October 2020 and February/March 2021). These surveys assessed psychological distress, loneliness, social support, family conflict, as well as other pandemic stressors. Information on developmental antecedents were obtained when cohort members were 17years of age. Four distinct trajectories class were identified. Normative class (52.13%) experienced low and decreasing levels of psychological distress, while moderately increasing class (31.84%) experienced a small, but significant increase in distress over time and increasing class (8.75%) exhibited a larger increase in distress after the first wave of the pandemic. Inverted U-shaped class (7.29%) experienced elevated psychological distress during the first wave of the pandemic, followed by a decrease in distress in subsequent waves of the pandemic. Larger longitudinal increases in loneliness were noted among individuals in the elevated distress trajectory, compared to other trajectories. Pre-pandemic psychopathology was associated with elevated distress early in the pandemic. The largest trajectory showed low and declining psychological distress, highlighting the resilience of the majority of late adolescents. However, a subgroup of adolescents experienced large increases in psychological distress, identifying a group of individuals more vulnerable to pandemic-related stress.

Basic Psychological Needs and Mental Health in Adolescents with a Mild to Borderline Intellectual Disability

ABSTRACT Introduction Emotional and behavioral problems are common in adolescents with mild to borderline intellectual disabilities (MBID). Basic Psychological Needs Theory connects fulfillment of basic psychological needs (autonomy, relatedness, competence) to ill-being (mental health problems). The associations between the frustration and satisfaction of basic psychological needs and indicators of mental health problems are the subject of this study. Method Adolescents with MBID (N = 324, mean age 15.2 years), filled out questionnaires on basic psychological needs (BPNSFS-ID) and on anxiety (SCARED), depression (CDI) and aggression (Externalizing Problems scale of YSR). A subgroup of adolescents with MBID and severe behavioral problems (MBID-SBP) was compared to a general subgroup (MBID-G). Results Outcomes for adolescents with MBID-SBP were worse than for adolescents with MBID-G on most measures. BPNSFS-ID frustration was positively associated with mental health problems. Correlations for the BPNSFS-ID satisfaction scales were positive but weaker. Associations within the MBID-SBP subgroup were stronger than for the MBID-G subgroup. Discussion Frustration of BPN in particular is associated with mental health problems. Attending basic psychological needs may potentially help to counter ill-being.

Eating disorder risk in adolescent and adult female athletes: the role of body satisfaction, sport type, BMI, level of competition, and training background

BackgroundEating disorders negatively influence athletes’ health and performance. To achieve a high level of performance and conform to cultural expectations regarding an athletic body type, female athletes often restrict their diets, which can lead to eating disorders. In addition to factors related to the sports environment, adolescent athletes are subject to changes caused by the maturation process. Therefore, the same factors may have different effects on eating disorder risk among adolescent and adult athletes. This study examined the relationship between eating disorder risk, specific aspects of the sports environment (sport type, level of competition [national and international], and training background), and individual aspects (body satisfaction and body mass index) in two groups of athletes: adolescents and adults.MethodsThe sample included 241 highly trained female athletes aged 12–30 years (M = 20.68, SD = 4.45) recruited from different sports clubs in Poland. The subgroup of adolescents consisted of 82 athletes, while the number of adult athletes was 159. The Eating Attitudes Test questionnaire was used to assess the eating disorder risk among the athletes. Body satisfaction was measured using the Feelings and Attitudes Toward Body Scale incorporated into the Body Investment Scale.ResultsEating disorder risk was prevalent among 14.6% of the adolescent and 6.9% of the adult athletes. Significant associations between eating disorder risk and the studied variables were noted only among adolescent athletes. Univariate logistic regression analysis revealed that the occurrence of eating disorder risk was associated with participation in lean non-aesthetic sports (OR = 11.50, 95% CI: 3.58–37.09). Moreover, eating disorder risk was associated with athletes’ lower body satisfaction (OR = 0.80, 95% CI: 0.70–0.92). Body mass index was not included in the final regression model.ConclusionsThe study indicated that eating disorder risk in adolescent female athletes was related to sport type and body satisfaction. The findings showed that, in adolescent athletes, eating disorder risk was the most associated with practicing lean non-aesthetic sports. Coaches and athletes should be aware that eating disorder risk increases among individuals with a lower body image.

Assessing the Feasibility of Economic Approaches to Prevent Substance Abuse Among Adolescents: Protocol for a Mixed Methods Study.

Adolescent alcohol and drug use (ADU) is a significant public health challenge. Uganda, one of the poorest countries in Sub-Saharan Africa (SSA), has the second-highest rate of per capita alcohol consumption in SSA, and over one-third of Ugandan adolescents have used alcohol in their lifetime (over 50% of them engage in heavy episodic drinking). These estimates further increase in fishing villages, a key HIV-vulnerable population, where ADU is normative. However, few studies have assessed ADU among adolescents and youths living with HIV despite their increased risk for ADU and its impact on engagement in HIV care. Moreover, data on risk and resilience factors for ADU are scarce as only few studies evaluating ADU interventions in SSA have reported positive outcomes. The majority have been implemented in school settings, potentially excluding adolescents in fishing communities with high school dropout rates, and none have targeted risk factors including poverty and mental health, which are rampant among adolescents and youths living with HIV and their families, undermine their coping skills and resources, and have been associated with increased risk for ADU among them. We propose a mixed methods study with a sample of 200 adolescents and youths living with HIV (aged 18-24 years) seen at 6 HIV clinics in southwestern Uganda's fishing communities to (1) examine the prevalence and consequences of ADU and identify the multilevel risk and resilience factors associated with ADU among them and (2) explore the feasibility and short-term effects of an economic empowerment intervention on ADU among them. This study comprises four components: (1) focus group discussions (FGDs) with adolescents and youths living with HIV (n=20) and in-depth qualitative interviews with health providers (n=10) from 2 randomly selected clinics; (2) a cross-sectional survey with 200 adolescents and youths living with HIV; (3) a randomized controlled trial with a subgroup of adolescents and youths living with HIV (n=100); and (4) 2 postintervention FGD with adolescents and youths living with HIV (n=10 per group). Participant recruitment for the first qualitative phase has completed. As of May 4, 2023, ten health providers from 6 clinics have been recruited, provided written consent to participate, and participated in in-depth qualitative interviews. Two FGDs was conducted with 20 adolescents and youths living with HIV from 2 clinics. Data transcription, translation, and analysis of qualitative data has commenced. The cross-sectional survey will commence shortly after and dissemination of the main study findings is targeted for 2024. Our findings will advance our understanding of ADU among adolescents and youths living with HIV and inform the design of future interventions to address ADU among them. ClinicalTrials.gov NCT05597865; https://clinicaltrials.gov/ct2/show/NCT05597865. PRR1-10.2196/46486.

Teacher Perceptions of Past Classroom Behaviors Influence Adolescents’ Receptivity and Responsiveness to a Belonging Intervention

This study shows how receptivity and responsiveness can influence the efficacy of an intervention helping adolescents reappraise worry or uncertainty following the difficult transition to middle school. The intervention was implemented at-scale in a diverse sample of sixth-grade public school district students followed through eighth grade (N = 1,180; 41% Black or Latinx; 44% low socioeconomic status). Results suggest the intervention’s effects on grade point average are confined to a racially and socioeconomically diverse subgroup of adolescents who had high teacher evaluations of their classroom behaviors in kindergarten that declined over the early elementary school years (i.e., “Disengagers”). These findings suggest that adolescents’ past school experiences with educators may bound the extent to which interventions can promote success in school.

Anxiety as a differentiating variable in emotional recognition in juvenile offenders with high callous-unemotional traits.

The presence of so-called callous-unemotional (CU) traits-lack of remorse/empathy, callous use of others and shallow/deficient affect-defines an important subgroup of children and adolescents with more severe and stable antisocial behaviours over time and may be a precursor to so-called psychopathy in adults. There are two main hypotheses to account for such traits, one emphasising deficits in recognition of specific emotions-the distress specific-and the other in aspects of facial recognition-the attention to the eyes hypothesis, but it may be that the manifestation of deficits is affected by the person's own emotional state. To test the effect of anxiety scores on emotion recognition among young people high scoring for CU traits. 14- to 21-year-olds serving sentences in youth justice institutions across Spain were invited to participate. Only those scoring above the cut-off on the Kimonis Inventory of Callous and Unemotional Traits were included. Anxiety was measured using the State-Trait Anxiety Inventory. Emotion recognition was assessed using the Emotional Face and Emotional Gaze Tasks. Of 91 (90% male) eligible participants, 53 had above threshold anxiety scores. The latter group recognised the emotional expressions of sadness, anger and fear earlier than their non-anxious peers, both when only the eye region was presented and when full faces were presented. There was less difference between groups in the case of the emotions of disgust and happiness, with both groups recognising these emotions earlier and more accurately when a full face was presented. Our findings suggest that 14- to 21-year old who struggle with callous emotional traits should not be treated as a homogenous group but that testing for other relevant problems, including anxiety, may inform optimal routes to the emotion recognition training that is likely to help them relate to others more prosocially.

Th137Cs radionuclides, folate cycle and physical development of children living near the Chornobyl exclusion zone

The purpose of the study: to assess the impact of incorporated 137Cs radionuclides on the physical development of boys and girls living near the Chornobyl Exclusion Zone, taking into account the state of the folate cycle and the MTHFR:C677T genetic polymorphism. Research methods: іnstrumental, laboratory, mathematical and statistical. Results: Within the framework of international projects, an assessment of physical development was carried out according to the Rohrer index (IR), the levels and relationship of incorporated 137Cs, vitamins B6, B9, B12, homocysteine (Hcy), allelic variants of the MTHFR:C677T genetic polymorphism were determined in 260 children aged 13-17 years old from Ivankivskyi and Polisskyi districts of the Kyiv region, bordering the Chornobyl Exclusion Zone. It has been established that among the surveyed, the more proportion is the subgroup of adolescents with harmonious physical development (respectively, for boys - 70.40%, for girls - 65.93%). It was shown that boys and girls with disharmonious high physical development (respectively 15.20% and 25.19%) contained significantly less 137Cs radionuclides in their bodies, compared with children from the subgroups of harmonious and disharmonious low physical development. In the analyzed groups of boys and girls, an inverse correlation was recorded between the specific activity of 137Cs and the values of anthropometric indicators. The most pronounced inverse relationship between the specific activity of 137Cs and the values of mass, as well as body length and IR, was found in the subgroup of harmoniously developed girls. The subgroup of harmoniously developed boys differed from the subgroup of harmoniously developed girls by a higher specific activity of 137Cs in the body and a higher level of Hcy in the blood. The decrease in the level of Hcy in the blood of harmoniously developed girls, compared with harmoniously developed boys, may be associated with a higher level of vitamin B12 in the blood, as well as with a more intense functioning of the trans-sulfurization cycle. Comparative analysis showed that in the subgroup of girls with overweight, the proportion of cases of carriage of genotypes composed of neutral alleles of the C/C polymorphism MTHFR:677 is greater than in the subgroup of harmoniously developed girls. At the same time, a lower specific activity of 137Cs in their body was registered. It is concluded that incorporated 137Cs radionuclides cause a decrease in body weight in children living in the area affected by the accident at the Chоrnobyl nuclear power plant. At the same time, there is a metabolic disorder, in the form of an increase in the content of Hcy in the blood, more pronounced in boys. The process of incorporation of 137Cs radionuclides into the body of children may be associated with the T allele of the MTHFR:C677 polymorphism, which affects the activity of methylenetetrahydrofolate reductase.

Somatosensory abnormalities after infection with SARS-CoV-2 - A prospective case-control study in children and adolescents.

BackgroundLong-term neurological complaints after SARS-CoV-2 infection occur in 4–66% of children and adolescents. Controlled studies on the integrity of the peripheral nerve system are scarce. Therefore, we examined the somatosensory function in children and adolescents after SARS-CoV-2 infection in a case-control study compared with age-matched individuals.Materials and MethodsEighty-one subjects after SARS-CoV-2 infection (n = 44 female, 11.4 ± 3.5 years, n = 75 SARS-CoV-2 seropositive, n = 6 PCR positive during infection and SARS-CoV-2 seronegative at the time point of study inclusion, n = 47 asymptomatic infection) were compared to 38 controls without SARS-CoV-2 infection (26 female, 10.3 ± 3.4 years, n = 15 with other infection within last 6 months). After standardised interviews and neurological examinations, large fibre (tactile and vibration detection thresholds) and small fibre (cold and warm detection thresholds, paradoxical heat sensation) functions were assessed on both feet following a validated protocol. After z-transformation of all values, all participants were compared to published reference values regarding the number of abnormal results. Additionally, the mean for all sensory parameters values of both study groups were compared to an ideal healthy population (with z-value 0 ± 1), as well as with each other, as previously described. Statistical analyses: t-test, Chi-squared test, and binominal test.FindingsNone of the controls, but 27 of the 81 patients (33%, p < 0.001) reported persistent complaints 2.7 ± 1.9 (0.8–8.5) months after SARS-CoV-2 infection, most often reduced exercise capacity (16%), fatigue (13%), pain (9%), or paraesthesia (6%). Reflex deficits or paresis were missing, but somatosensory profiles showed significantly increased detection thresholds for thermal (especially warm) and vibration stimuli compared to controls. Approximately 36% of the patients after SARS-CoV-2, but none of the controls revealed an abnormal sensory loss in at least one parameter (p < 0.01). Sensory loss was characterised in 26% by large and 12% by small fibre dysfunction, the latter appearing more frequently in children with prior symptomatic SARS-CoV-2 infection. Myalgia/paraesthesia was indicative of somatosensory dysfunction. In all eight re-examined children, the nerve function recovered after 2–4 months.InterpretationThis study provides evidence that in a subgroup of children and adolescents previously infected with SARS-CoV-2, regardless of their complaints, the function of large or small nerve fibres is presumably reversibly impaired.

A Multi-Country Study of Risk and Protective Factors for Emotional and Behavioral Problems Among Early Adolescents

PurposeEarly adolescence (ages 10–14) is a critical period for psychosocial development, but few studies have focused on risk and protective factors for emergent psychosocial challenges among youth living in low- and middle-income countries. This study explored the contribution of social environmental factors to patterns of emotional and behavioral problems among early adolescents across four low- and middle-income countries. MethodsParticipants were drawn from the Global Early Adolescent Study, and included 10,437 early adolescents from six low-resource urban settings in the Democratic Republic of Congo, Malawi, Indonesia, and China. Multivariate latent class regression was used to examine the associations between distinct patterns of emotional and behavioral problems and risk and protective factors across the family, peer, school, and neighborhood levels. ResultsAcross countries, childhood adversity, peer bullying behaviors, and a perceived lack of school safety were consistently associated with emotional and behavioral problems. With some contextual variability, peer substance use and a perceived lack of neighborhood safety also emerged as significant risk factors. The magnitude of these associations was generally greatest among a subgroup of early adolescents with co-occurring emotional and behavioral problems. DiscussionThe overall consistency of findings across countries is suggestive of the generalizability of risk factors in early adolescence and indicates that interventions bolstering psychosocial adjustment among this age group may have applicability in diverse cross-national settings. Given the significance of peer bullying behaviors and school safety, multicomponent school-based interventions may be an especially applicable approach.