Youth Psychosocial Functioning Research Articles

Body image and psychosocial outcomes in youth and young adults with differences of sex development: a multi-method study.

Differences of sex development (DSD) can affect the physical health, appearance, and psychosocial functioning of affected individuals, but little is known about how subjective appearance perceptions (body image) impact psychosocial outcomes. This study evaluated body image and its associations with psychosocial outcomes including quality of life, resilience, and psychosocial adjustment. This cross-sectional, multi-method study assessed body image and psychosocial outcomes including quality of life, adjustment, and resilience in 97 youth and young adults with DSD (mean age = 17 ± 3.7 years; 56% assigned female in infancy) using psychometrically sound instruments. A subsample (n = 40) completed qualitative interviews. Quantitative results indicated that overall, participants were satisfied with their physical appearance, although less so with their primary sex characteristics. Body image dissatisfaction was associated with poorer psychosocial adjustment, quality of life, and resilience. Qualitatively, youth and young adults reported a variety of perceptions, both positive and negative, related to their body image and the impact of living with a DSD condition. Themes identified included appearance management; effects of DSD on body image; diagnostic factors and features; attitudes about diagnosis; and treatment. Body image is significantly associated with psychosocial outcomes in youth and young adults with DSD, with qualitative findings highlighting both positive and negative body image experiences. Results have implications for clinical care including screening for appearance concerns, normalization of appearance variations, and intervention development to better support healthy body image and psychosocial functioning in youth and young adults with DSD.

A randomized controlled trial examining the effect of camp HOPE Tennessee on youth functioning: Results from a pilot study.

Family violence can negatively affect youth's psychosocial functioning. Strengths-based interventions may enhance positive youth functioning among youth experiencing adversity, but little is known about the effectiveness of camp-based interventions for youth exposed to family violence. The current study examined the effectiveness of Camp HOPE Tennessee in promoting multidimensional well-being and school engagement among youth exposed to family violence. This pilot study employed a nonmasked, parallel randomized controlled design. Participants were 47 children and their caregivers who sought services from a Family Justice Center. Children were 7-12 years old (M = 9.55, SD = 1.63; 79% Black/African American). Using block randomization, caregiver-child dyads were assigned to the camp (n = 23) or waitlist control (n = 24) condition and completed evaluations at baseline, 2-month follow-up, and 5-month follow-up. Children reported on two indicators of positive functioning: multidimensional Quality of Life (i.e., Physical Well-Being, Psychological Well-Being, Autonomy And Parent Relations, Social Support And Peers, And School Environment) and School Engagement. Piecewise latent growth curve models evaluated between-group differences in positive youth functioning at 2- and 5-month follow-up (ClinicalTrials.gov: CampHopeTN). Results suggest that Camp HOPE positively impacted children's psychological well-being (difference = 12.28, SE = 2.84, p < .001, g = 0.94) and autonomy and parent relations (difference = 7.96, SE = 2.95, p = .007, g = 0.77) at 2-month follow-up. Additionally, the camp appeared to have a long-term effect on school engagement at 5-month follow-up (difference = 9.97, SE = 4.83, p = .039, g = 0.59). Results suggest that camp interventions may enhance positive functioning among youth exposed to family violence. Larger investigations are needed to strengthen the evidence base for Camp HOPE's effectiveness and support further dissemination. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

727-P: Improvement in Psychosocial Functioning of Youth with Diabetes and Their Caregivers with Multiple Social Risk Factors

Background: Social determinants of health (SDOH) lead to health disparities. Novel Interventions in Children's Healthcare (NICH) is a community-based program for youth with chronic conditions such as diabetes, with a high degree of social risk. We describe changes in depressive symptoms, diabetes distress, and diabetes strengths in youth with diabetes and their caregivers who completed one year in NICH at UCSF. Methods: NICH participants in this analysis had diabetes and were ≥12 years old. All completed the Patient Health Questionnaire-8 (PHQ-8), Problem Area in Diabetes-Teen (PAID-T), and those ≥14 years completed the Diabetes Strength and Resilience measure for adolescents (DSTAR-Teen) at baseline and one year. Caregivers completed the parent PAID-T (P-PAID-T). Paired t-tests were used to compare scores at baseline and one year when scores for both time points were available. Results: Participants included 15 youth with type 1 and 1 with type 2 diabetes. Mean age was 15.4 ± 1.6 years, 88% were from historically marginalized racial or ethnic groups, and 94% had public insurance. Families had a mean of 8 ± 4.8 social risk factors at baseline, the most common being educational barriers, mental health needs, and trauma. Mean PHQ-8 scores decreased from 8.4 ± 6.4 at baseline to 4.3 ± 5.4 at one year (p=0.014, n=10). Mean PAID-T scores trended towards decreasing from baseline (70.7 ± 19.8) to one year (58.8 ± 22.9, p=0.24, n=10), and mean P-PAID-T scores significantly decreased from 57.3 ± 17.8 to 45.3 ± 16.8 (p=0.044, n=6). Mean DSTAR-Teen scores increased from 44.6 ± 6.3 to 48.9 ± 8.1 at one year (p=0.065, n=8). Conclusions: Participation in NICH is associated with fewer depressive symptoms, less caregiver diabetes distress, and a trend towards reduced distress in youth and improved diabetes-specific strengths. Further research on SDOH among underrepresented populations is needed, as interventions mitigating social risk have potential to improve psychosocial outcomes. Disclosure A.Reed: None. M.A.Harris: None. M.Lodish: None. J.C.Wong: Research Support; Dexcom, Inc., Tandem Diabetes Care, Inc. C.E.Noya: None. D.V.Wagner: None. J.H.Lim: None. V.Glocker: None. K.S.Bal: None. M.Gonzales granados: None. A.Stone: None. M.T.Mcgrath: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust

Explicit and implicit bias among parents of sexual and gender minority youth.

Sexual and gender minority (SGM) youth are at disproportionate risk for poor mental health outcomes, in part due to experiences and expectations of anti-SGM bias including from their own parents. We examined explicit anti-SGM and implicit antisexual minority bias in parents of SGM youth and associations with parenting and parent and youth psychosocial functioning. Heterosexual/cisgender parents (N = 205, Mage = 46.9 years, SD = 8.5) of SGM youth (≤ 29 years old, Mage = 19.4, SD = 4.7) completed an online study including measures of explicit anti-SGM and implicit anti-SM bias, parental acceptance and psychological control, parent-child unfinished business (unresolved negative feelings related to their child's identity), parental depression and anxiety, and youth anxiety, depression, substance use, and exposure to bullying. In models including both explicit anti-SGM and implicit anti-SM bias as predictors of parent and youth outcomes, explicit bias was uniquely associated with lower parental acceptance and greater parental psychological control, parent-child unfinished business, parental anxiety and depression, and youth substance use and exposure to bullying, whereas implicit bias was uniquely associated with greater parent-child unfinished business and parental depression. Further, the combination of high levels of both explicit and implicit bias was associated with the highest levels of parent-child unfinished business, parental depression, and youth anxiety, depression, and exposure to bullying. Results suggest that both types of bias jointly contribute to parenting and parent and youth psychosocial functioning and can help identify families at greatest risk for maladjustment. Findings can inform the development of interventions designed to reduce anti-SGM bias in parents of SGM youth. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Anger as a Mechanism of Injustice Appraisals in Pediatric Chronic Pain

Mechanisms explaining the relationship between pain-related injustice appraisals and functional outcomes in youth with chronic pain have yet to be examined. In studies of adults, greater pain-related injustice is associated with worse depressive symptoms and greater pain through greater anger. No study to date has examined anger expression as a mediator in the relationships between pain-related injustice appraisals and physical and psychosocial functioning in youth with chronic pain. The current sample consisted of 385 youth with varied pain conditions (75% female, 88% White, Mage=14.4 years) presenting to a university-affiliated pain clinic. Patients completed self-report measures assessing anger expression (anger-out and anger-in), pain-related injustice, pain intensity, functional disability, and emotional, social, and school functioning. Bootstrapped mediation analyses indicated that only anger-out (indirect effect= -.12, 95% CI: -.21, -.05) mediated the relationship between pain-related injustice and emotional functioning, whereas both anger-out (indirect effect= -.17, 95% CI: -.27, -.09) and anger-in (indirect effect= -.13, 95% CI: -.09, -.001) mediated the relationship between pain-related injustice and social functioning. Neither mode of anger expression mediated the relationship between pain-related injustice and pain intensity, functional disability, or school functioning. Collectively, these findings implicate anger as one mechanism by which pain-related injustice impacts psychosocial outcomes for youth with chronic pain. PerspectiveAnger expression plays a mediating role in the relationship between pain-related injustice appraisals and psychosocial outcomes for youth with chronic pain. Anger represents one target for clinical care to decrease the deleterious impact of pain-related injustice on emotional and social functioning.

Sociodemographic factors and health-related, neuropsychological, and psychosocial functioning in youth with spina bifida.

Objective: Past research suggests that certain sociodemographic factors may put youth with spina bifida (SB) at risk for poor outcomes. The aims of this study were to examine (a) associations between ten sociodemographic factors and health-related, neuropsychological, and psychosocial functioning among youth with SB,(b) cumulative sociodemographic risk as a predictor of youth outcomes as moderated by age, and (c) SB-related family stress as a mediator of longitudinal associations between cumulative sociodemographic risk and youth outcomes. Method: Participants were youth with SB (N = 140 at Time 1; Mage at Time 1 = 11.43, 53.6% female) recruited as part of a larger, longitudinal study. The study included questionnaire (parent-, teacher-, and youth-report), neuropsychological testing, and medical chart data across three time points, spaced 2 years apart. Results: A subset of the sociodemographic factors and their cumulative risk were associated with study outcomes. Specifically, youth characterized by sociodemographic risk had greater pain and lower academic achievement, but also fewer urinary tract infections and fewer attention and executive function problems. Age did not moderate the association between cumulative risk and outcomes. Cumulative risk predicted lower SB-related family stress, which, in turn, predicted several outcomes. Conclusions: Examining a range of sociodemographic factors is warranted. Sociodemographic risk is linked to poorer outcomes for some risk indicators but similar or better outcomes for others. Results have implications for delivering evidence-based, diversity-sensitive clinical care to youth with SB. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Lithium works for youth with BD too: Study

Consistent with adult studies, a recent analysis of data from the Course and Outcome of Bipolar Youth (COBY) study found that lithium is associated with decreased suicidality, less depression, and better psychosocial functioning in youth.

The relationship between family acceptance-rejection and transgender youth psychosocial functioning.

The relationship between family acceptance-rejection and transgender youth psychosocial functioning.

The role of fatigue in functional outcomes for youth with chronic pain.

As a complex multidimensional construct, fatigue may play an important role in the physical and psychosocial functioning of youth with chronic pain. Based on a model previously tested in adults, the current study similarly utilized patient-reported outcomes measurement system (PROMIS) to examine how fatigue contributes to functional outcomes for youth with chronic pain. The model tested self-reported ratings of pain intensity, depressive symptoms and sleep disturbance as predictors of outcomes (mobility, pain-related interference and school functioning) as mediated by ratings of fatigue. Two hundred and eighty-five youth with chronic pain ages 8-17years and their caregivers, completed surveys as part of their initial clinical evaluation at a tertiary paediatric pain clinic. Study measures included: paediatric PROMIS domains (mobility, pain interference, sleep disturbance, fatigue and depressive symptoms), Paediatric Quality of Life school functioning and pain intensity. All mediated effects were calculated via a 1,000-draw bootstrap estimation method in Mplus. Fatigue was found to be a statistically significant mediator of the effects of pain intensity, sleep disturbance and depressive symptoms on outcomes of pain interference, mobility and school functioning. While pain intensity was found to independently contribute to mobility and pain interference, depressive symptoms did not show significant effects on any outcome beyond its association with fatigue. Sleep disturbance predicted pain interference while fatigue predicted school functioning. Findings suggest that fatigue is an important intervening factor for functional outcomes among youth with chronic pain. Targeting fatigue may be effective in optimizing school functioning and reducing the deleterious effects of depressive symptoms. This cross-sectional study highlights fatigue as a potential clinical target by applying a path analytic model to understand its possible significance and distinction from overlapping constructs such as pain intensity, depression and sleep disturbance. Further study of fatigue may be important in understanding its importance in treatment of paediatric chronic pain.

Implementing Juvenile Drug Treatment Courts: A Meta-aggregation of Process Evaluations

Juvenile drug treatment courts (JDTCs) continue to be popular. However, results of a recent meta-analysis raised doubts regarding their effectiveness over traditional juvenile justice system processing. The objective of this study was to systematically review the qualitative and quantitative evidence related to the inner workings of JDTCs to identify ways to improve outcomes. We conducted an extensive systematic search for process and implementation studies, resulting in 59 studies that met eligibility criteria. We used meta-aggregation methods to extract 477 study findings and categorized the findings thematically. We report on a subset of findings within four thematic categories containing the largest number of methodologically credible findings: (1) family members as stakeholders in the JDTC process, (2) standards for ensuring accountability and youth compliance with court expectations, such as the consistent application of behavioral contingencies, (3) the availability of community and school services, and (4) the various needs of JDTC clients, such as mental health treatment. Based on these findings, we suggest a modified causal change model for JDTCs that extends the theoretical framework for JDTCs to incorporate improving youth psychosocial functioning as an important outcome. Implications for the role of JDTCs within the juvenile justice system are discussed.

Psychosocial Functioning After One Year of Interdisciplinary Pediatric Weight Management

Youth with obesity are more likely than normal-weight peers to experience psychosocial problems. Empirically-based recommendations for addressing pediatric obesity include intensive interdisciplinary weight management comprising medical, behavioral health, nutrition, and exercise components. The present study examined changes in psychosocial functioning associated with frequency of participation in an interdisciplinary pediatric weight management program. Participants were 86 patients (55.8% females; median age = 11.5 years; 67.4% Non-Hispanic Black; median BMI percentile = 99.5) enrolled in an interdisciplinary pediatric weight management program for at least one year. Psychosocial functioning was measured with the Pediatric Symptom Checklist (PSC-17), a caregiver-completed mental health screen that assesses internalizing, externalizing, and attention difficulties as well as global functioning. The PSC-17 was completed at the initial clinic visit (baseline) and repeated one-year later (annual). The Wilcoxon Signed Rank test indicated that annual PSC-17 scores were significantly lower than baseline scores across all domains. Spearman correlation coefficients revealed no significant association between total number of clinic visits and PSC-17 global or subscale scores. However, the number of visits for exercise-only sessions was significantly correlated with caregiver-reported improvement in internalizing behaviors. Findings suggest that participation in interdisciplinary pediatric weight management may improve psychosocial functioning in youth with obesity and that attending supervised exercise sessions may be especially beneficial for improving internalizing behavior symptoms.

The Back2School modular cognitive behavioral intervention for youths with problematic school absenteeism: study protocol for a randomized controlled trial

BackgroundSchool absenteeism (SA) is associated with anxiety, depression, and disruptive behavior. It is a risk factor for academic difficulties and school dropout, which predict problems in adulthood such as social, work-related, and health problems. The main goal of this study is to examine the initial effectiveness of a modular transdiagnostic cognitive behavioral therapy (CBT) intervention (Back2School) for increasing school attendance and decreasing psychological problems, relative to a comparator control arm (treatment as usual [TAU]).Methods/designOne hundred sixty children, aged 7 to 16 years, will be randomly assigned to either Back2School or TAU. The design is a two (Back2School and TAU) by four (preassessment [T1], postassessment [T2], and 3-month [T3] and 1-year [T4] assessments) mixed between-within design. The primary outcome is school attendance based on daily registration. Secondary outcomes pertain to youth psychosocial functioning, quality of life, bullying, self-efficacy, and teacher-parent collaboration. These secondary outcomes are measured via youth, parent, and teacher reports.DiscussionThis study will provide critically needed empirical evidence on the initial effectiveness of a manualized treatment program for youth with SA. If the intervention is found to be effective, the program can be further implemented and tested in a larger school health effectiveness trial.Trial registrationClinicalTrials.gov, NCT03459677. Retrospectively registered on 9 March 2018.

Supplemental Material for The Relationship Between Family Acceptance-Rejection and Transgender Youth Psychosocial Functioning

Supplemental Material for The Relationship Between Family Acceptance-Rejection and Transgender Youth Psychosocial Functioning

Discrepancies between parent and self-reports of adolescent psychosocial symptoms: Associations with family conflict and asthma outcomes.

Discrepancies often exist between self-reported and parent-reported symptoms when assessing youth psychosocial functioning. Parent-child discrepancies in ratings may be important for understanding psychopathology and patterns of family functioning, particularly during adolescence and for youth with chronic illness. This study examined patterns of multirater reporting discrepancies in a pediatric asthma population. Adolescents (n = 707; 11-17 years old) and their primary caregivers completed ratings of adolescents' psychological symptoms. Latent profile analysis identified five profiles of parent-adolescent discrepancies, including one group with highly discordant ratings, two groups in agreement, and two groups with slightly discordant ratings. Adolescents who agreed with their parents on the presence of elevated symptoms and those who had significant discrepancies in ratings, such that parents reported elevated symptoms compared to youth self-report, had poor pulmonary functioning and elevated reports of parent-rated family conflict. Results suggest the need to assess internalizing and externalizing symptoms in adolescents with asthma using a multirater approach while also highlighting the complexity in interpreting patterns of discrepancies. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Featured Article: Psychosocial and Family Functioning Among Latino Youth With Spina Bifida.

This study examined differences in psychosocial and family functioning between Latino and non-Latino Caucasian youth with spina bifida (SB), and examined family functioning as a predictor of youth psychosocial functioning as moderated by ethnicity. Participants were part of a larger, longitudinal study (Devine, Holbein, Psihogios, Amaro, & Holmbeck, 2012) and included 74 non-Latino Caucasian youth with SB and 39 Latino youth with SB (M age = 11.53, 52.2% female). Data were collected at Time 1 and 2 years later, and included questionnaire and observational data of psychosocial and family functioning. Latino youth demonstrated fewer externalizing symptoms, less family conflict, but also less social competence. Family conflict was associated with psychosocial functioning in Latino youth, while family cohesion, conflict, and stress were associated with psychosocial functioning in non-Latino Caucasian youth. Psychosocial and family functioning, and their relationship over time, may be different in Latino versus Caucasian youth with SB.

The role body-esteem plays in impairment associated with hair-pulling and skin picking in adolescents

Trichotillomania (hair pulling disorder, HPD) and pathological skin picking (PSP) are associated with significant rates of psychosocial impairment and distress. Little research has addressed the physical consequences and associated impairment in youth (e.g., poor body-esteem). The present study explores the relationship between body-esteem, skin picking (SP), and pulling-related impairment in a sample of adolescents with primary HPD. Ninety four adolescents who pull their hair, 40 of whom also pick their skin, were recruited via internet-sampling as part of the Child and Adolescent Trichotillomania Impact Study (CA-TIP). All youth and a parent completed anonymous questionnaires online assessing psychiatric symptoms, repetitive behaviors, and psychosocial impairment, among other variables. Appearance-based body-esteem was not found to be predictive of more severe psychosocial impairment in these youth. However, SP, in combination with HPD, contributed to worse appearance-based body-esteem above and beyond symptoms of HPD alone. The current study suggests that psychosocial functioning in youth with HPD is less impacted by body-esteem or pulling than other factors (e.g., depression and anxiety), and that SP contributes to lowered body-esteem. These findings suggest the importance of addressing body-esteem in case conceptualization for youth with both HPD and SP. Further research is required to confirm these suggestions.

Longitudinal Course of Bipolar Disorder in Youth With High-Functioning Autism Spectrum Disorder

To provide the first longitudinal characterization of mood and psychosocial functioning in youth with comorbid bipolar (BD) and autism spectrum (ASD) disorders. The Course and Outcome of Bipolar Youth study followed 368 youth (aged 7-17 years) with DSM-IV bipolar I (BP-I), BP-II, or Not Otherwise Specified (NOS) for, on average, 9 years using the Longitudinal Interval Follow-up Evaluation. This subgroup analysis compared youth with and without ASD on clinical presentation, percentage of time with mood symptomatology, and psychosocial functioning. Thirty youth (∼8%) met DSM-IV criteria for Asperger's disorder or pervasive developmental disorder-NOS (referred to here as ASD). Lifetime worst episode severity wassimilar in both groups, but youth with both BD and ASD (BD+ASD) had elevated rates of comorbid attention-deficit/hyperactivity and obsessive-compulsive disorders, were younger at intake, and had an earlier onset of mood symptoms. Over time, in both groups, the proportion of predominantly euthymic youth increased, and episode recurrence decreased. Compared to youth with BD, the clinical presentation of youth with BD+ASD more frequently involved distractibility, racing thoughts, depressed mood, social withdrawal, and low reactivity of negative mood states. ASD-related symptomatic differences were generally strongest early and decreased over time. Youth with BD+ASD had significantly greater impairment in friendships throughout follow-up. Youth with BD+ASD exhibit typical BD mood symptoms but with earlier onset, mixed symptom presentation, and additive functional impairments. Significant amelioration of clinical symptoms occurred over time, suggesting that early recognition and treatment of mood disorders in youth with ASD may improve clinical outcomes.

Evaluation of a Youth with Sexual Behavior Problems (YSBP) Outpatient Treatment Program

Sexual behavior problems usually involve intimidation or force and can be harmful. Evidence-based practices for youth with sexual behavior problems (YSBP) are needed. This study involved a program evaluation at an urban community mental health program for YSBP which incorporated cognitive-behavioral therapy methods. Secondary data was collected from case files of 28 male youthful offenders, ages 11–17, from an urban community-based mental health center. Results suggest that there were significant improvements in youth psychosocial functioning and parenting stress, and significant decreases in parent–child dysfunctional interaction. However, there was no significant change in Sexual Interests, Attitudes, and Behaviors. Although there were several limitations to the evaluation, improvements in critical areas such as psychosocial functioning, parenting and parent–child relations are promising. Suggestions to improve the program are discussed along with future research that is needed.

Quality of Life in Obese Youth With and Without Sleep Problems

This study compared quality of life (QOL) and psychosocial functioning of youth who are overweight and obese, with and without sleep troubles. A total of 80 youth (8-17 years) and their parents completed questionnaires assessing child QOL, psychosocial functioning, and sleep during an outpatient Obesity Clinic appointment. Twenty-nine percent of children reported sleep troubles. Youth with sleep troubles reported lower QOL and more internalizing problems than youth without sleep troubles. Longitudinal research with repeated measurement and use of validated measures of sleep is warranted. These preliminary data suggest improved sleep may help increase behavioral and psychosocial functioning in obese youth.

Hatha Yoga for Pediatric Obesity: A Pilot Study

Objective: Little is known about the benefits of yoga for pediatric obesity, and no studies have examined the benefits of yoga for physical activity in either adults or children. The purpose of this pilot study was to examine whether Hatha yoga would improve overall, physical and psychosocial functioning in youth with severe obesity. We also sought to determine whether participants would increase the vigor of, and time spent in, physical activity. Methods: This study utilized a pre-test/post-test design. Sixteen youth with severe obesity completed an 8 week Hatha yoga intervention involving fifteen, 60-minute classes. Physical and psychosocial functioning, fitness and state-anxiety were assessed at baseline and post-intervention; parents completed proxy-reports of physical and psychosocial functioning at both time points. To assess physical activity, participants wore an Actical Accelerometer for 7 days pre and post-yoga. Results: Significant improvements were found in: Overall, Physical and Psychosocial functioning, back and hamstring flexibility, and state-anxiety. Changes in the proportion of time spent in both light and moderate levels of physical activity were marginally significant. Although 3 tests of fitness, and time spent in physical activity did not improve significantly, trends were in the expected direction. Conclusions: Youth with severe obesity may benefit from a Hatha yoga intervention. Yoga may also offer a way to engage in physical activity that is not precluded by bodily pain.