Symptoms In Youth Research Articles

Avoidant/Restrictive Food Intake Disorder (ARFID) Symptoms in Adolescent Patients With Disorders of Gut-Brain Interaction.

Disorders of gut-brain interaction (DGBI) and avoidant/restrictive food intake disorder (ARFID) share clinical characteristics. However, research on the prevalence of ARFID symptoms in youth with DGBI and the clinical presentation of DGBI youth with varying levels of ARFID symptoms is limited. In this cross-sectional observational study, 38 adolescents (range 12-17 years; 71% female) with a diagnosed DGBI receiving treatment at a pediatric gastroenterology clinic and a primary caregiver completed the Nine Item ARFID Screen (NIAS). Gastrointestinal (GI), psychiatric, quality of life (QOL), and weight/growth outcomes were assessed via youth- and caregiver-reported questionnaires, anthropometrics, and a water load test. ARFID symptoms were characterized, and their associations with GI, psychiatric symptoms, QOL, and weight/growth outcomes were analyzed. Clinically significant ARFID symptoms were reported by 42% of youth and 55% of caregivers. ARFID symptoms were associated with more severe GI and psychiatric symptoms, lower QOL, and clinically significant weight loss or faltering growth. While associations became non-significant after false discovery rate correction, the effect sizes were medium to large, clearly demonstrating meaningful associations. Agreements between youth and caregiver NIAS reports were good to excellent. ARFID symptoms are common in adolescents with DGBI and associated with clinical severity. Further elucidating this common co-morbidity and developing guidelines for effective co-management are priorities.

The link between delayed affective recovery from daily stressors and anxiety symptoms in youth.

The link between delayed affective recovery from daily stressors and anxiety symptoms in youth.

Effects of an Organizational Implementation Strategy on Sustainment of Measurement-Based Care in Community Mental Health.

Little is known about how to sustain evidence-based interventions with fidelity in community mental health settings. Phase 1 of the Working to Implement and Sustain Digital Outcome Measures (WISDOM) trial showed that an organizational strategy improved the implementation of measurement-based care (MBC) in mental health services for youths 1-12 months after clinician MBC training. The authors report results from phase 2 of the trial, in which the strategy's effects on MBC sustainment 13-26 months after clinician MBC training were examined. Twenty-one outpatient mental health clinics were randomly assigned to MBC training and technical assistance plus the Leadership and Organizational Change for Implementation (LOCI) strategy (11 clinics) or to training and technical assistance only (10 clinics). In phase 2, the primary outcomes of MBC completion rate, youth symptom improvement, and MBC fidelity were examined for 452 youths who entered treatment 13-26 months after clinician MBC training. No differences were found in MBC completion rate or symptom improvement between the two conditions; however, among the 81 youths who received MBC, fidelity was significantly higher at LOCI sites relative to control sites (24%, SE=11.1 vs. 1%, SE=1.0, respectively; p=0.003). During phase 2, LOCI sites (vs. control sites) sustained superior MBC fidelity when MBC was used; however, superior MBC completion rates and clinical outcomes were not sustained. Sustainment of MBC may require strategies that improve its fit with regulatory and reimbursement environments in addition to strategies that develop clinic infrastructure.

Temporal Tendencies: Exploring the Impact of Chronotype Timing on Youth Depression Risk.

Developmental changes in youth sleep preferences (chronotype) and pubertal development are consequential for youth risk for depression. Previous research has identified individual differences in chronotype in risk for psychopathology. However, little is known regarding how the timing of chronotype may confer risk in youth. This study addressed this gap by examining associations between chronotypal timing and symptoms of depression in youth. Community youth (N = 155; =12.7) completed self-report measures of chronotype, pubertal status and depression every six months for a period of one year (three assessment points). Regression analyses showed that chronotypal timing predicted change in depressive symptoms across six months (b = -0.66, p = 0.019), but not across any other timeframe. Findings suggested that youth experiencing more of a morning preference compared to same-aged peers were at increased risk for later depression across six months. Chronotypal timing continued to predict changes in symptoms of depression controlling for gender (b = -0.63, p = 0.023) and pubertal timing (b = -0.72, p = 0.012). These findings suggest that chronotypal timing is prospectively related to changes in youth symptoms of depression. Results indicate that attention to the timing of normative changes in chronotype is warranted, in addition to mean-level differences.

Selected determinants of anxiety and depression symptoms in adolescents aged 11-15 in relation to the pandemic COVID-19 and the war in Ukraine.

The ongoing COVID-19 pandemic, which began in early 2020, and the outbreak of war in Ukraine in 2022 (a country bordering Poland on the east) have significantly impacted the mental health of young people in Poland, leading to increased rates of depression, anxiety, and other mental health issues. The rising number of individuals struggling to cope with daily stressors, as well as non-normative stressors, may indicate a decrease in the individual's potential, specifically in skills, attitudes, and competencies required to overcome difficulties that they encounter. It can be assumed that for young people, maintaining mental health under the influence of social stressors, such as the pandemic and the ongoing war in Ukraine, depends on the ability to adapt positively, which is the ability of young individuals to adjust to situational demands in a way that allows them to effectively manage those situations. The aim of the conducted study was to determine whether social stressors, namely the pandemic and the war in Ukraine, and intrapsychic factors such as beliefs about oneself, others, life, and the world, influence the occurrence of anxiety and depression symptoms in Polish youth. An attempt was made to assess the significance of external stressors and internal potential resources for maintaining psychological balance among young people. The study was conducted using the Revised Children's Anxiety and Depression Scale (RCADS), the Questionnaire of Intrapersonal, Interpersonal, and World Attitudes (QIIWA), as well as a survey created by the researchers containing questions about well-being in relation to the pandemic, remote learning, and the ongoing war in Poland's neighboring country. Ethical approval for the planned research was obtained from the Bioethics Committee. The study included 945 adolescents aged 11-15 years (M = 13.10; SD = 1.11), representing a sample of youth from 14 regions of Poland. The results and analyses are presented from three perspectives: (A) the occurrence of anxiety and depression symptoms in relation to the gender and age of the respondents, (B) the significance of situational experiences, such as the COVID-19 pandemic (Q1), remote learning (Q2), and the outbreak of the war in Ukraine (Q3) for the occurrence of anxiety and depression symptoms in Polish youth, and (C) other determinants of anxiety and depression symptoms in Polish youth, such as intrapsychic variables including self-esteem, satisfaction with relationships with others, and views on the world and life. It can be concluded that in the case of young people, maintaining mental health under the influence of social stressors such as the pandemic and the ongoing war in Ukraine depends mainly on intrapsychic variables, including the beliefs and attitudes of young people towards themselves, toward other people, the world and life.

Autistic Girls but Not Boys Show a Strong Association Between Internalizing Symptoms and Social Motivation.

The current study examined the associations between internalizing symptoms, social motivation, and gender among autistic and non-autistic youth. Caregivers of 386 participants age 6 to 14 years completed measures of their child's internalizing symptoms and social motivation. Correlation and hierarchical regression analyses were conducted to compare internalizing symptoms and social motivation across autistic and non-autistic girls and boys. Social motivation was found to be higher among non-autistic participants compared to autistic participants, with no significant gender differences observed in social motivation within groups. Social motivation was found to be a significant predictor of internalizing symptoms. The association between social motivation and internalizing symptoms varied by gender and diagnostic status. Higher internalizing symptom scores were associated with lower social motivation among autistic girls, non-autistic girls, and non-autistic boys, but no association was found among autistic boys. The current study found that the relations between social motivation and anxiety, depression, and somatization symptoms in autistic youth varied by gender. The strong association between internalizing symptoms and social motivation among autistic girls and not autistic boys may be due to the unique social experiences and expectations associated with the intersecting gender and neurodivergent identities of autistic girls. The findings of the current study underscore the value of adopting an intersectionality perspective by considering both the influence of gender and neurodivergent identities together when addressing the social experiences and mental health of autistic youth.

Development and Validation of a Brief Age-Normed Screening Tool for Subthreshold Psychosis Symptoms in Youth.

Improvements in screening tools for early subthreshold psychosis symptoms are needed to facilitate early identification and intervention efforts, especially given the challenges of rapidly differentiating age-appropriate experiences from potential early signs of emerging psychosis. Tools can be lengthy and time-consuming, impacting their utility and accessibility across clinical settings, and age-normed data are limited. To address this gap, we sought to develop and validate a brief, empirically derived, age-normed, subthreshold psychosis screening tool, for public use. Computerized adaptive test simulation was used to derive a 5-item short form with age norm equivalencies from a 12-item PRIME-Screen-Revised (PRIME-12) administered to 7053 youth (Mage = 15.8, SD = 2.7; 54% female; 33% Black). Concurrent validity was assessed (n = 758) using contemporaneous administration of the PRIME-5 and the Structured Interview for Prodromal Syndromes. Comparability of criterion-related validity of the PRIME-5, PRIME-12, and Scale of Prodromal Symptoms (SOPS) was assessed by relating scores to psychosis-risk-relevant criteria. Finally, self-report versus assessor-administered PRIME total scores were compared (n = 131) to assess their concurrent validity. Correlations among PRIME-5, PRIME-12, and SOPS were comparable and moderate, supporting their convergent validity. The PRIME-5 also showed comparable criterion-related validity, demonstrating similar relationships with psychosis-risk indicators as the other tools. Self-reported and assessor-administered PRIME-5 were moderately correlated. Public availability of a brief, age-normed, and validated screening tool-which can be assessor or self-administered-will expedite and improve early identification of youth (age 11 and older) at risk for psychosis.

Anterior pituitary gland volume mediates associations between adrenarche and changes in transdiagnostic symptoms in youth.

The pituitary gland (PG) plays a central role in the production and secretion of pubertal hormones, with documented links to the increase in mental health symptoms during adolescence. Although literature has largely focused on examining whole PG volume, recent findings have demonstrated associations among pubertal hormone levels, including dehydroepiandrosterone (DHEA), PG subregions, and mental health symptoms during adolescence. Despite the anterior PG's role in DHEA production, studies have not yet examined potential links with transdiagnostic symptomology (i.e., dysregulation) pertinent to long-term functioning. Therefore, the current study sought examine whether anterior PG volume mediates associations between DHEA levels and changes in dysregulation symptoms in an adolescent sample (N = 114, 9 -17 years, Mage = 12.87, SD = 1.88). Following manual tracing, structural equation modeling revealed that greater anterior, not posterior, PG volume mediated the association between greater DHEA levels and increasing dysregulation symptoms across time, controlling for baseline dysregulation symptom levels. Results also showed that greater DHEA levels related to decreasing symptoms across time, suggesting potential attenuation effects. Altogether, these results provide support for separating the anterior and posterior PG by demonstrating specificity in the role of the anterior PG in adrenarcheal processes that may confer risk for adolescent psychopathology.

Medical and Socioeconomic Risk Factors for Academic and Psychological Outcomes in Pediatric Sickle Cell Disease

Risk factors for poor neuropsychological outcomes are not fully understood in youth with sickle cell disease (SCD). We examined the associations between medical factors (SCD genotype, silent infarct/stroke, etc), socioeconomic factors (insurance type), and neuropsychological outcomes (reading and math achievement, psychological symptoms) in youth with SCD. A chart review was conducted for 108 Black/African American youth with SCD (Mage = 10.80, SD = 3.53, 54.6% males) referred for neuropsychological evaluation. Patients were administered Wechsler-series tests of intelligence and academic achievement. Psychological symptoms were measured using the caregiver report Child Behavior Checklist. Zero-order correlations, analyses of variance (ANOVAs), and hierarchical linear regression models examined the associations between variables. Youth with less severe SCD genotypes (SC/SBeta+ thalassemia) had more externalizing problems. Youth with Medicaid/no insurance had more internalizing, externalizing, and somatic symptoms. Low full-scale intelligence quotient (FSIQ) strongly predicted poor academic achievement scores above other factors. Results highlight the importance of early neuropsychological/psychosocial screenings in SCD.

Understanding the role of perfectionism in contributing to internalizing symptoms in youth with juvenile idiopathic arthritis.

Youth with juvenile idiopathic arthritis (JIA) experience elevated rates of internalizing symptoms, although more research is required to understand this phenomenon. Perfectionism, a multidimensional personality trait that involves dimensions such as striving for flawlessness (self-oriented perfectionism) and feeling that others demand perfection (socially-prescribed perfectionism), is a well-known risk factor for internalizing symptoms that has received minimal attention in pediatric populations. Preregistered hypotheses explored the relationships between youth and parent perfectionism and symptoms of depression and anxiety in youth with JIA, as mediated by (a) youth/parent negative self-evaluations and (b) youth self-concealment. One hundred fifty-six dyads comprised of youth (13-18 years) with JIA and a caregiver completed online questionnaires about trait perfectionism, negative self-evaluations (i.e., pain catastrophizing and fear of pain), self-concealment, and internalizing symptoms. Positive relationships were observed between parent/youth self-oriented perfectionism and negative self-evaluations, youth self-oriented perfectionism and internalizing symptoms, and youth negative self-evaluations and internalizing symptoms. Parent self-oriented perfectionism was negatively related to youth depression symptoms. Indirect effects were observed for youth self-oriented perfectionism predicting anxiety and depression symptoms through pain catastrophizing (a1b1 = 0.13 and 0.12, 95% CI [.03, .24 and .03, .22], respectively). Exploratory mediations suggested youth socially-prescribed perfectionism might predict internalizing symptoms directly and indirectly through self-concealment. Youth and parent perfectionism are implicated in the internalizing symptoms of youth with JIA and may manifest through youth negative self-evaluations (e.g., catastrophic thoughts) and self-concealment. While future research is needed, screening for perfectionistic tendencies in this population may help guide assessment, prevention, and treatment efforts.

Pain-Related Injustice Appraisals, Sickle Cell Stigma, and Racialized Discrimination in the Youth with Sickle Cell Disease: A Preliminary Investigation.

Despite the fact that perceptions of racialized discrimination, health-related stigma, and pain-related injustice have been associated with worse patient functioning, little is known about their unique relationships in Black youth living with sickle cell disease (SCD). In this study, we (1) examined the prevalence of perceptions of racialized discrimination, perceptions of health-related stigma, and pain-related injustice appraisals and (2) investigated how the aforementioned variables were uniquely related to functioning (i.e., functional disability, depressive, and anxiety symptoms) in Black youth living with SCD. The study sample included 30 non-Hispanic Black or African American youth living with SCD (17 male, 13 female youths). The average age of the sample was approximately 11.3years (SD = 2.73). Zero-order correlations and hierarchical regressions were used to examine and compare the multivariate relationships between perceived racialized discrimination, perceived health-related stigma, and perceived pain-related injustice and outcome variables (functional disability, anxiety symptoms, and depressive symptoms). For functional disability, perceived racialized discrimination and perceived pain-related injustice were significant predictors in the final model (F(3,26) = 11.00, p < .01). For depressive symptoms, health-related stigma trended toward significance (p = .09) as a predictor in the final model (F(2,26) = 6.69, p < .01). For anxiety symptoms, perceived pain-related injustice was the only significant predictor in the final model (F(3,26) = 10.25, p < .001). Results suggest that the youth living with SCD experience and perceive racialized discrimination, health-related stigma, and injustice surrounding their pain experience and these factors are associated with worse outcomes.

Shared and unique lifetime stressor characteristics and network connectivity predict adolescent anxiety and depression.

Exposure to major life stressors and aberrant functional connectivity have been linked to anxiety and depression, especially during adolescence. However, whether specific characteristics of life stressors and functional network connectivity act together to differentially predict anxiety and depression symptoms remains unclear. We utilized baseline lifetime stressor exposure and resting-state functional magnetic resonance imaging data in a longitudinal sample of 107 adolescents enriched for anxiety and depressive disorders. We examined five stressor characteristics: physical danger, interpersonal loss, humiliation, entrapment, and role change/disruption. Anxiety and depression symptoms were assessed at baseline, 6-month and 12-month follow-ups. Linear mixed-effect models tested if lifetime severity of these stressor characteristics, functional connectivity within and between frontoparietal, default, and ventral attention networks, and their interactions differentially predicted anxiety and depression symptoms at two 6-month follow-ups. Greater lifetime severity of physical danger and humiliation predicted higher anxiety symptoms. Greater lifetime entrapment severity predicted higher anxiety and depression symptoms. After including within- and between-network functional connectivity and other predictive characteristics, only the effects of lifetime entrapment severity remained significant. Lifetime entrapment severity more strongly predicted anxiety symptoms in youth with higher default network connectivity. Greater functional connectivity between frontoparietal and default networks predicted increased depression symptoms. Our study is the first to use lifetime severity of distinct stressor characteristics and resting-state functional connectivity jointly to predict adolescent anxiety and depression symptoms. These results imply certain stressor characteristics and functional connectivity metrics as specific predictors of anxiety or depression and highlight entrapment as a shared predictor for anxiety and depression.

Investigating the general psychopathology factor in autistic youth

Investigating the general psychopathology factor in autistic youth

Perceptions of youth internalizing symptoms: Cross-cultural comparisons between Taiwanese and U.S. mothers.

This study was designed to examine how cultural values affected mothers' perceptions of internalizing symptoms in youth, comparing Taiwanese and U.S. samples. We hypothesized that mothers' self-reported East Asian cultural values (e.g., conformity, emotional self-control, face culture) would mediate the relationship between their country of residence and perceptions of youth's depressed mood and anhedonia. Participants were 310 mothers from the United States and 294 mothers from Taiwan. All participants responded to questions regarding their adherence to specific East Asian cultural values. Four brief vignettes about a male adolescent experiencing internalizing symptoms were presented to all participants. After reading each vignette, participants rated their perceptions of the adolescent's symptoms. Results from a series of multilevel structural equation models indicated that Taiwan mothers reported more East Asian cultural values (conformity, emotional self-control, face culture) compared to U.S. mothers, which in turn led to rating youth internalizing problems as less acceptable, more impairing, and more problematic to the family, and feeling less proud and more ashamed of the youth. There was also an inconsistent mediation effect of East Asian cultural values on the relationship between country and rating of anhedonia. The mediation pathway was non-significant for the rating of depressed mood. In conclusion, to improve cultural understanding, researchers and clinicians should consider the driving force of the observed between-group differences to ensure appropriate conceptual frameworks in a cross-cultural context. Cross-cultural differences in ratings of youth symptoms highlight the importance of a culturally sensitive approach to assessing symptoms and functional impairment in different cultural groups.

Cognitive-Behavioural Social Skills Training: Mediation of Treatment Outcomes in a Randomized Controlled Trial for Youth at Risk of Psychosis: L'entraînement aux compétences sociales cognitivo-comportementales : variables médiatrices des résultats thérapeutiques dans le cadre d'un essai clinique randomisé pour les jeunes présentant un risque de psychose.

Currently, there are no effective treatments for functional outcomes (i.e., role and social) and negative symptoms for youth at clinical high-risk (CHR) for psychosis. Investigations into possible mechanisms that may contribute to the improvement of functioning and negative symptoms are needed in CHR research to help inform psychosocial treatments. The present study examined whether functioning and negative symptoms were mediated by asocial beliefs, defeatist beliefs, self-efficacy, maladaptive schemas, anxiety, depression, social cognition, or attenuated psychotic symptoms (APS) in a large clinical trial. CHR participants (n = 203; 104 females; 99 males) were recruited as part of a three-site randomized control trial comparing group cognitive-behavioural social skills training (CBSST) versus a supportive therapy group. Mediation analyses were conducted to test the relationships between treatment group, mediators (asocial beliefs, defeatist beliefs, self-efficacy, maladaptive schemas, anxiety, depression, social cognition, and APS), and outcome (social and role functioning, and negative symptoms). The mediation analyses employed conditional process path analysis via ordinary least squares regression. At the end of treatment, but not 12-month follow-up, more severe APS were found to mediate the impact of treatment on negative symptoms, and social and role functioning. The greater the severity of APS, the less likely that CBSST would result in improvement in negative symptoms and social and role functioning. Many of the other variables showed significant associations with social (less for role) functioning and negative symptoms but did not mediate the effect of treatment on these outcomes at the end of treatment or 12-month follow-up. There were no significant mediators except for APS at the end of treatment. Since more severe APS may result in participants being unable to fully participate in therapy and thus limit their gains, clinical implications may include offering some individual therapy to prepare these young people to benefit from the group treatment.

Examining racial and ethnic differences in youth psychotherapy treatment engagement and outcomes.

Research has identified racial/ethnic disparities in mental health treatment engagement, and there have been recent calls to examine effects of mental health treatment engagement on clinical outcomes among youth of color. This study aimed to examine racial/ethnic differences in (a) behavioral and attitudinal engagement, (b) treatment effectiveness, and (c) the associations between engagement and treatment effectiveness. N = 200 youth (ages 7-15; 33% White, 28% Black, 25% Hispanic/Latinx, and 14% multiracial; 52% male) and their N = 200 parents participated in a randomized controlled trial testing the effectiveness of a transdiagnostic psychotherapy for common youth emotional and behavioral problems. Youth and parents reported internalizing and externalizing symptoms and treatment engagement (e.g., behavioral and attitudinal). Multilevel regression models examined variations in youth symptom trajectories by racial/ethnic group. While all racial/ethnic groups showed comparable attitudinal engagement scores, Black and Latinx youth attended significantly fewer sessions than White and multiracial youth (8-9 vs. 13). However, youth in all racial/ethnic groups showed significant and similar improvements in treatment outcomes. Black and Latinx youth attended fewer sessions than White youth, but their clinical outcomes were similar to those of White youth. Future research should examine the meaning and implications of session attendance in relation to outcomes in youth of color. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Mental health of Finnish cis- and transgender youth before, during and after the COVID-19 pandemic

Abstract Background Transgender youth report more mental health problems than their cisgender peers, but little is known about their mental health during and after the COVID-19 pandemic. We studied symptoms of anxiety and depression among cis- and transgender youth before, during, and after the pandemic using large nationwide samples. Methods Data from the Finnish School Health Promotion survey from years 2019, 2021 and 2023 (461,249 students in total; mean age 15.7, SD 1.3) were used. Self-reports covered official gender, gender identity, symptoms of anxiety (Generalized Anxiety Disorder Scale-7 ≥10) and depression (Patient Health Questionnaire-2 ≥3). Categories of cisgender boy (officially boy; gender identity boy; N = 214,423), transfeminine youth (officially boy; gender identity girl, both, neither, or it varies; N = 5,069), cisgender girl (officially girl; gender identity girl; N = 224,753), and transmasculine youth (officially girl; gender identity boy, both, neither, or it varies; N = 14,508) were formed. Results In all timepoints, proportion of those with anxiety or depression was higher among transfeminine youth compared with cisgender boys and among transmasculine youth compared with cisgender girls. In all groups anxiety and depression increased significantly from 2019 to 2021 (ORs 1.4-1.8, p &amp;lt; 0.0001), with no significant differences in these changes between cis- and transgender groups. From 2021 to 2023, anxiety (OR 0.91, p = 0.015) and depression (OR 0.77, p &amp;lt; 0.0001) decreased among transmasculine youth but increased among cisgender girls (ORs 1.11 [p &amp;lt; 0.0001] and 1.07 [p &amp;lt; 0.0001], interactions p &amp;lt; 0.0001). Among transfeminine youth, generalized anxiety symptoms decreased from 2021 to 2023, whereas they remained at the level observed in 2021 among cisgender boys (interaction p = 0.0025). Conclusions In Spring 2023, we found still increasing mental health problems among cisgender girls, while among transgender youth the post-pandemic developments were more positive. Key messages • Post-pandemic, we found further increases in mental health symptoms in cisgender youth, while among transgender youth the development seemed more promising. • Transgender youth experience more anxiety and depression than their cisgender peers, thus gender diversity deserves still more attention in educational, social, and health care services.

Cluster Analysis of Migraine-associated Symptoms (CAMS) in youth: A retrospective cross-sectional multicenter study.

To conduct a retrospective cross-sectional multicenter study to validate the relationships between migraine-associated symptoms. Symptoms associated with headache-photophobia and phonophobia, nausea, and/or vomiting-are required criteria for migraine diagnosis based on the International Classification of Headache Disorders-Third Edition (ICHD-3). However, individuals with migraine report high rates of other symptoms (e.g., lightheadedness, difficulty thinking). We recently completed a single-center study assessing the relationships between an expanded set of migraine-associated symptoms. A pre-registered cross-sectional multicenter retrospective analysis was conducted on standardized questionnaire data of youth ages 6-17 years from two headache registries at pediatric tertiary care centers. Cluster Analysis of Migraine-associated Symptoms (CAMS) was implemented to assess associations between 11 migraine-associated symptoms. We explored differences between the two centers, and how CAMS was associated with demographics, including sex and age, and headache burden. There were 10,721 participants who were 66.5% female and had a median (interquartile range) age of 13 (10-15) years. The first three CAMS dimensions accounted for 46.5% of the variance and were consistent across sites. The first dimension indicated those reporting any migraine-associated symptoms were likely to report multiple. The second dimension separated symptoms into those included in ICHD-3 migraine diagnostic criteria and non-ICHD symptoms (e.g., lightheadedness, difficulty thinking). The third dimension separated sensory hypersensitivity and vestibular symptoms. An abundance of migraine-associated symptoms correlated with greater headache severity (Spearman's ρ = 0.18, 95% confidence interval [CI] 0.17-0.20; small effect size) and disability (ρ = 0.26, 95% CI 0.25-0.28; small effect size). We also observed differences in associated symptoms across age and sex. Associations between an expanded set of migraine-associated symptoms are informative for headache burden and reveal intriguing changes across child development and sex. We were able to replicate findings across two centers, indicating that these symptom clusters are inherent to migraine.

Multisystemic Resilience and Anxious-Depressed Symptoms in Black Youth Exposed to Maternal Syndemics: A Mixed-Method Study.

We explored associations between multisystemic resilience and anxious-depressed symptoms in Black families experiencing maternal syndemics (i.e., co-occurring epidemics of substance abuse, violence, HIV/AIDS), using a sequential explanatory study design. Hierarchical regression was used to analyze data from 171 Black youth (57% girls; Mage=12.13, SD = 2.90). Girls (β=-0.17, p = .02) with higher inter/intrapersonal skills (β = - 0.28, p = .004) and more open familial communication (β = - 0.40, p < .001) reported fewer anxious-depressed symptoms, F(12, 147) = 5.68; p < .001, Adj R2 = 26.1%. Qualitative results from a subsample of 10 Black youth-mother dyads explored inter/intrapersonal factors (i.e., emotion regulation strategies, goal setting, persistence and perseverance, problem-solving skills) and open communication factors (i.e., comfortable environment to talk, solving problems, processing feelings, showing affection, benefiting from open communication) that support Black youth resilience. Findings highlight key resilience factors that could be bolstered in future interventions to reduce anxious-depressed symptoms among Black youth exposed to maternal syndemics.

Within-Person Effects of Executive Functioning on Anxiety and Depressive Symptoms in Youth with Neurodevelopmental Disorders: A Longitudinal Study

Abstract Objectives The objective was to disentangle the role of between- and within-person variation in executive functioning (EF) in the development of anxiety and depressive symptoms among youth with neurodevelopmental disorders. Methods We assessed 85 youth with ADHD, 38 youth with autism spectrum disorder (ASD), and 50 typically developing (TD) youth at baseline (Mage = 11.7 years, 64% males), 2-year follow-up, and 10-year follow-up with neuropsychological tests of EF and anxiety and depressive symptoms scales. Results Across groups, depressive symptoms increased with age, whereas anxiety symptoms were stable. Greater within-person improvement in overall EF from baseline to 2-year follow-up predicted reduced anxiety symptoms. Greater within-person improvement in cognitive flexibility predicted reduced depressive symptoms from baseline to 2-year follow-up. Conclusions We conclude that improvement in EF skills in youth may lessen the severity of anxiety and depressive symptoms over time. Thus, EF could be an intervention target to prevent anxiety and depressive symptoms.