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Individuals with a family history of bipolar disorder are at increased risk of developing affective psychopathology. Longitudinal imaging studies in young people with familial risk have been limited, and cortical developmental trajectories in the progression towards illness remain obscure.
Aims
To establish high-resolution longitudinal differences in cortical structure that are associated with risk of bipolar disorder.
Method
Using structural magnetic resonance imaging data from 217 unrelated ‘Bipolar Kids and Sibs study’ participants (baseline n = 217, follow-up n = 152), we examined changes over a 2-year period in cortical area, thickness and volume, measured at each vertex across the cortical surface. Groups comprised 105 ‘high-risk’ participants with a first-degree relative with bipolar disorder (female n = 64; age in years: M (mean) = 20.9, s.d. = 5.5) and 112 controls with no familial psychiatric history (females n = 60; age in years: M = 22.4, s.d. = 3.7).
Results
Accelerated thickness and volume reductions over time were observed in ‘high-risk’ individuals across multiple cortical regions, relative to controls, including right lateral orbitofrontal thickness (β = 0.033, P < 0.001) and inferior frontal volume (β = 0.021, P < 0.001). These differences were observed after controlling for age, sex, ancestry, current medication status, lifetime psychiatric diagnoses and measures of gross brain morphology.
Conclusions
Longitudinal group differences suggest the presence of thicker cortex in familial ‘high-risk’ individuals at earlier developmental stages, followed by accelerated thinning towards the typical age of bipolar disorder onset. Future examination of genetic and environmental components of familial risk and the mechanistic nature (pathological or protective) of cortical-trajectory differences over time may facilitate the identification of prodromal biomarkers and opportunities for early clinical intervention.
Depression runs in families, with both genetic and environmental mechanisms contributing to intergenerational continuity, though these mechanisms have often been studied separately. This study examined the interplay between genetic and environmental influences in the intergenerational continuity of depressive symptoms from parents to offspring.
Methods
Using data from the Dutch TRAILS cohort (n = 2201), a prospective, genetically informed, multiple-generation study, we examined the association between parents’ self-reported depressive symptoms (reported at mean age of 41 years) and offspring depressive symptoms, self-reported nearly two decades later, in adulthood (mean age: 29 years). We assessed the role of genetic (polygenic scores for depressive symptoms in parents and offspring) and environmental mechanisms (parental warmth during adolescence) in explaining intergenerational continuity of depressive symptoms in separate and combined models.
Results
Parents’ depressive symptoms, offspring genetic predisposition, and parental warmth were associated with an increased risk of depressive symptoms in offspring. In the combined model, parents’ genetic predisposition was linked to their own depressive symptoms, which were linked to lower parental warmth, which, in turn, was linked to higher depressive symptoms in offspring, after accounting for offspring genetic predisposition, sex, age, and socioeconomic status.
Discussion
Both genetic and environmental mechanisms contribute to the intergenerational continuity of depressive symptoms independently and in interplay. Despite a significant effect, the influence of parental warmth was modest, suggesting limited covariation between this particular parenting measure and depressive symptoms, at least when assessed with large temporal distance.
The current study examined how early smartphone ownership impacts parent-child informant discrepancy of youth internalizing problems during the transition to adolescence. We used four waves of longitudinal data (Years 1–4) from the Adolescent Brain Cognitive Development (ABCD; Baseline N = 11,878; White = 52.0%, Hispanic = 20.3%, Black = 15.0%, Asian = 2.1%, Other = 10.5%; Female = 47.8%). Across the full sample, significant parent-child informant discrepancy, such that parents underestimated child reports, appeared at Year 2 (Mage = 12.0) and increased across the remainder of the study (b = −0.21, SE = .042, p < .001, 95%CI [−.29, −.23]). Further, multi-group models indicated that significant parent-child informant discrepancy emerged in the years following initial smartphone acquisition, whereas youth who remained non smartphone owners did not demonstrate such a pattern. Moreover, this discrepancy grew with additional years of smartphone ownership. This study contributes to the ongoing discourse on adolescent smartphone use and mental health by documenting a novel, longitudinally observed risk to timely parental detection of mental health problems by early smartphone ownership.
Cross-sectional and longitudinal evidence indicates that the error-related negativity (ERN) increases across adolescence. However, there are no longitudinal studies of ERN development which traverse all of adolescence. In addition, anxiety (e.g., generalized and social anxiety) and depression have been associated with a larger and smaller ERN, respectively, but it is unknown whether childhood psychopathology is associated with adolescent development of the ERN. In the present study, 317 8 to 14-year-old girls completed a flanker task at baseline and approximately 2-year and 5-year follow-ups. Multilevel growth modeling was used to examine ERN trajectory across adolescence and test whether self-reported childhood generalized anxiety, social anxiety, and depression symptoms at baseline predicted ERN trajectory. On average, the ERN demonstrated a linear increase from late childhood to early adulthood. Additionally, participants with high baseline anxiety (generalized anxiety, social anxiety) and low depression symptoms had the steepest ERN trajectory across adolescence. The present study provides longitudinal support for an increase in the ERN spanning adolescence and demonstrates that childhood psychopathology is associated with error-related neural development into early adulthood.
Previous studies investigating the association between pubertal timing and depression in girls primarily use self-reported age at menarche (AAM). This study examines a range of pubertal timing indicators, including anthropometric and self-reported measures.
Aims
Compare associations of multiple indicators of pubertal timing with depressive symptoms and depression in girls and explore whether these associations persist into early adulthood.
Method
The sample comprised 4607 girls from UK-based Avon Longitudinal Study of Parents and Children. Seven measures of pubertal timing were assessed between ages 7 and 17 (age at: peak height velocity (aPHV); peak weight velocity; peak bone mineral content velocity; Tanner pubic hair and breast development stage 3; axillary hair; and AAM). Depressive symptoms were measured at 14, 17, 18 and 24 years using the Short Mood and Feelings Questionnaire. Depression was assessed at 15, 18 and 24 years using the Development and Well-Being Assessment and Clinical Interview Schedule-Revised. Multivariable logistic regression models were adjusted for socioeconomic status and pre-pubertal body mass index.
Results
Later pubertal timing was associated with lower odds of depressive symptoms at age 14 across six measures, including aPHV (adjusted odds ratio (AOR): 0.82; 95% CI 0.72, 0.95) and AAM (AOR: 0.84; 95% CI 0.76, 0.92). Later AAM and Tanner breast stage 3 were associated with lower odds of depression at age 18 (AOR: 0.85; 95% CI 0.75, 0.97 and AOR: 0.83; 95% CI 0.72, 0.95, respectively). Associations attenuated by age 24.
Conclusions
Later pubertal timing was associated with reduced odds of depressive symptoms during mid-adolescence, with associations attenuating by adulthood.
Anhedonia is a common and impairing symptom of psychopathology that predicts negative outcomes and may undermine peer relationships. Anhedonia comprises both trait (stable, time-invariant) and state (dynamic, time-varying) components. Relative to trait anhedonia, state anhedonia may be more strongly related to proximal risk for deleterious outcomes. Yet, associations between state anhedonia and daily-life socio-affective experiences in adolescence are not well understood. Thus, the present study used ecological momentary assessment (EMA) to examine within-person associations between state anhedonia and the quantity and quality of daily-life peer interactions among a sample of adolescents enriched for suicidality risk, a population at high risk for anhedonic and peer problems. Participants included 102 adolescents assigned female at birth (ages 12–18; M[SD] = 15.34[1.50]; 67.6% at elevated risk for suicidality). State anhedonia, as well as being with peers, connectedness with peers, and positive affect with peers, was measured three times per day for 10 days via EMA (n = 30 prompts). Multilevel models demonstrated that within-person fluctuations in state anhedonia relate to reduced odds of being with peers, as well as decreased connectedness and positive affect with peers. Findings suggest that dynamic changes in state anhedonia are related to both the quantity and quality of peer experiences among adolescents.
Repetitive transcranial magnetic stimulation (rTMS) has gained regulatory approval as an adjunctive treatment for obsessive–compulsive disorder (OCD) in adults. However, its application in adolescents remains largely untested. This editorial examines the limited evidence available, focusing on choice of target, stimulation depth and methodological variation. Ethical challenges surrounding the use of rTMS in vulnerable populations, including informed consent and the unknown long-term effects on neurodevelopment, are also discussed. Although rTMS holds promise for treatment-resistant adolescent OCD, a cautious and ethically rigorous approach is essential before wider clinical adoption can be considered.
This study longitudinally examined associations between parent and peer relationships, childhood maltreatment, and adolescents’ psychopathology. We expected lower perceived parental relationship quality to predict greater symptomatology and higher perceived friendship quality to buffer this association, with greater buffering effects for maltreated participants. We assessed 545 participants (295 maltreated, 250 non-maltreated; 60.2% male; 52.8% Black, 27.5% White, 12.8% Bi-racial, 13.4% Latin@) across two timepoints (Wave 1, Mage = 13.8 years, Wave 2,Mage = 16.2 years). Department of Human Services records indicated maltreatment status prior to Wave 1. Adolescents self-reported Wave 1 parental relationship and friendship quality and Wave 2 internalizing/externalizing symptoms. Parental relationship quality did not predict psychopathology, and this association did not differ by maltreatment status. We found a significant three-way interaction between maternal relationship quality, maltreatment, and friendship quality on internalizing (β = .10, p = .037) and externalizing (β = .12, p = .010) symptoms. For non-maltreated adolescents, parental relationships and friendship quality differentially predicted symptomatology. Maltreated adolescents with low maternal relationship and friendship quality exhibited the most symptoms, whereas those with low maternal relationship quality and high friendship quality exhibited the least. Findings invite inquiry into parent and peer relationships’ differential roles in adolescents’ psychopathology.
Understanding the effect(s) of the COVID-19 pandemic is key for planning for future pandemics.
Aims
This study examines change in self-reported mental health difficulties during three months of the pandemic among adolescent (10- to 15-year-olds) participants from the UK Household Longitudinal Study (waves 7, 9 and 11 of the main survey and waves 4, 5 and 8 of the COVID-19 surveys).
Method
We focused on mental health difficulties using the Strengths and Difficulties Questionnaire (SDQ), using repeated cross-sectional and longitudinal analyses to examine data among 6471 adolescents who responded to at least one survey since 2015, and 2,300 who responded to at least one COVID-19 survey during July 2020, November 2020 or March 2021.
Results
Repeated cross-sectional data showed similar mean total SDQ across surveys before and during the pandemic (range during pandemic 11.4 to 11.9; range pre-pandemic 11.1 to 11.8). Longitudinal analyses provided no evidence of mental health change compared with pre-pandemic trends (estimated change mean SDQ (β) = 0.05, 95% CI −0.42 to 0.51; p = 0.85), or differential sociodemographic effects, except greater effects in rural households (β = 0.67, 95% CI −0.08 to 1.41) than urban environments (β = −0.18, 95% CI −0.69 to 0.33). Though subscales generally saw higher scores during the pandemic than before, these were consistent with pre-pandemic trends, excepting a slight improvement in conduct problems (β = −0.26, 95% CI 0.12 to 0.40).
Conclusions
The study offers evidence among a representative sample that mental health difficulties did not, on average, deteriorate for adolescents during three months of the pandemic.
Climate change impacts and stresses young people and although their pro-environmental behaviours have been studied their perspectives have not been widely heard. This creative output is a lo-fi comic engaging with themes of imagined alternative futures in climate fiction. It was constructed to provide an example of a multimodal text with a low barrier to entry for use in the classroom, to complement the study of solar punk texts. The methodology of an autoethnographic art provides a tool for reflection and provides a suitably rebellious outlet for their perspectives, a departure from factual poster assignments on environmental issues. This particular perzine discusses the challenges faced by young people in addressing environmental issues and sustainable practice with limited personal agency.
There are an exceptional number of publications on the transition from elementary (primary) school to middle school, also known as secondary school, junior high school or lower-middle school. The major reason is that the transition to middle school is an event that has multiple and harmful implications. Several reasons contribute to the difficulty of secondary school adjustment, including misleading advertisement of the schools, a significant change in the teachers’ behavior and academic demands, and, especially, the developmental transitions to adolescence and the associated difficulties in managing parent-adolescent relationships. Relying on the P–E Fit Model, it is commonly agreed that the characteristics and demands that secondary schools impose on newcomers do not fit the needs of adolescents. In line with their developmental needs, secondary school are more oriented to their peers’ expectations than to those of their teachers and parents, and are more engaged in matters related to their self-esteem and social life, rather than learning “boring materials” or staying at school while their out-of-school life seems to be more exciting. Interventions to foster adjustment to secondary school are presented and discussed.
Adolescents frequently victimized by peers are two to three times more likely to develop an anxiety disorder than their non-victimized peers. However, the fine-grained mechanisms that explain how peer victimization confers risk for anxiety in adolescents’ daily lives are not well-understood. Leveraging an intensive longitudinal design, this study examined same- and cross-day links between peer victimization and anxiety, investigating social threat sensitivity as a potential underlying mechanism. One hundred ninety-five adolescents (Mage = 16.48, SDage = 0.35; 66% female, 27% male, 11% non-binary, identifying with another gender; 48% White, 20% Asian, 15% Black, 17% identifying with another race/ethnicity) completed brief daily assessments of peer victimization, social threat sensitivity, and anxious affect for 14 days. Multilevel analyses indicated that adolescents reported greater anxious affect on days when they experienced peer victimization compared to days without victimization. Although peer victimization did not predict anxious affect the following day, it was associated with increased anxious affect two days later. Social threat sensitivity significantly mediated the same-day, but not cross-day, association between peer victimization and anxious affect, controlling for prior-day threat sensitivity and anxiety. The findings suggest that heightened social vigilance partially accounts for anxious affect in adolescents facing peer victimization in daily life.
Mental ill-health has a major impact on young people, with pain often co-occurring. We estimated the prevalence and impact of pain in young people with mental ill-health.
Methods
Longitudinal data (baseline and three-month follow-up) of 1,107 Australian young people (aged 12–25 years) attending one of five youth mental health services. Multi-level linear mixed models estimated associations between pain characteristics (frequency, intensity, and limitations) and outcomes with false discovery rate (FDR) adjustment. Pain characteristics were baseline-centered to estimate if the baseline score (between-participant effect) and/or change from baseline (within-participant effect) was associated with outcomes.
Results
At baseline, 16% reported serious pain more than 3 days, 51% reported at least moderate pain, and 25% reported pain-related activity limitations in the last week. Between participants, higher serious pain frequency was associated with greater anxiety symptoms (β[95%CI]: 0.90 [0.45, 1.35], FDR-p=0.001), higher pain intensity was associated with greater symptoms of depression (1.50 [0.71, 2.28], FDR-p=0.001), anxiety (1.22 [0.56, 1.89], FDR-p=0.002), and suicidal ideation (3.47 [0.98, 5.96], FDR-p=0.020), and higher pain limitations were associated with greater depressive symptoms (1.13 [0.63, 1.63], FDR-p<0.001). Within participants, increases in pain intensity were associated with increases in tobacco use risk (1.09 [0.48, 1.70], FDR-p=0.002), and increases in pain limitations were associated with increases in depressive symptoms (0.99 [0.54, 1.43], FDR-p<0.001) and decreases in social and occupational functioning (−1.08 [−1.78, −0.38], FDR-p=0.009).
Conclusions
One-in-two young people seeking support for mental ill-health report pain. Youth mental health services should consider integrating pain management.
Ultra-processed food (UPF) consumption varies with socio-economic status (SES) in adults, and evidence suggests that similar patterns exist in adolescents. However, the relationship remains understudied in this critical developmental group. This study aimed to further characterise adolescent UPF consumption and its relationship with SES by exploring dietary patterns within UPF consumption.
Design:
Using food-diary data, adolescents’ UPF intake was quantified and categorised. Principal component and clustering analysis were used to identify dietary patterns. Associations of these dietary patterns with socio-demographic characteristics were then analysed.
Setting:
Pooled data from the rolling, cross-sectional National Diet and Nutrition Survey, waves 1-to-11 (2008–2019).
Subjects:
UK adolescents (11- to18-year-olds) (n 3199).
Results:
Three UPF dietary patterns were identified: (i) the ‘Restrictive’ pattern, which included the lowest total consumption of UPF (95 % CI: 33·1, 34·9 % g/d), but elevated consumption of UPF often perceived as healthy, was associated with adolescents of a higher SES; (ii) the ‘Permissive’ pattern included 61·6 % g/d (95 % CI: 60·3, 63·0 % g/d) total UPF, dominated by ‘ready-to-eat,’ low nutrient-density UPF, and was associated with adolescents of a lower SES and (iii) the ‘Traditional’ pattern had moderate consumption of total UPF (95 % CI: 47·6, 50·9 % g/d) with higher intake of UPF used in home-cooking and had less distinct associations with SES.
Conclusion:
Results suggest that SES impacts both the amount and type of UPF consumed by adolescents in the UK, underscoring the importance of this factor when designing interventions. Distinct dietary patterns within adolescents’ high UPF diets have potential behavioural, nutritional and health implications.
Executive functioning (EF) impairments are widely known to represent transdiagnostic risk factors of psychopathology. However, a recent alternative account has been proposed, according to which EF impairments emerge as consequences of psychopathology.
Methods
Using a longitudinal cross-lagged panel network analysis approach, we tested these competing theoretical accounts at different stages during adolescence. We used data from the Brazilian High-Risk Cohort Study for the Development of Childhood Psychiatric Disorders, in which 61% of individuals at wave 1 were selected due to their high risk for psychopathology. Participants were assessed across three assessment waves during early (wave 1: n = 1,992, mean age = 10.20 years) and middle adolescence (wave 2: n = 1,633, mean age = 13.48 years; wave 3: n = 1,439, mean age = 18.20 years). We examined associations between working memory, inhibitory control, and broad-band measures of psychopathology.
Results
During early adolescence, lower inhibitory control was a risk factor for externalizing problems that, in turn, predicted lower working memory capacity. During middle adolescence, bidirectional associations became more prominent: inhibitory control and working memory functioned as both risk factors and consequences. Externalizing problems both predicted and were predicted by poor inhibitory control. Internalizing and externalizing symptoms showed bidirectional associations over time. Externalizing problems predicted more internalizing symptoms, whereas internalizing symptoms predicted fewer externalizing problems during middle adolescence.
Conclusions
Our results corroborate dynamic theories that describe executive dysfunctions as precursors and consequences of psychopathology in middle adolescence.
From cradle to grave human beings actively strive to abstract meaning from experience. The meaning making capacity builds step-by-step, beginning in the earliest years. At each phase of life, new capacities emerge and previous limitations in meaning making can be overcome. By adolescence all of the basic tools for making meaning have been acquired. All that remains to be achieved is the wisdom that comes from accrued lived experience in the subsequent years. Increasingly, a narrative identity may be formed.
This study aimed to describe changes over time in the prevalence and associated factors of suicidal behaviours among 13– to 15–year–olds in Southeast Asian countries. It is a secondary analysis of cross-sectional data from the Global School-based Student Health Surveys conducted in Indonesia, Myanmar, the Philippines and Thailand in 2007/2008 and 2015/2016. Each survey included a nationally representative sample of students aged 13–15 years. Data on suicidal thoughts, plans, attempts, and associated factors—including health risk behaviours, experiences of physical violence and bullying, social difficulties, and parental supervision—were collected using self-report questionnaires. The population attributable fraction for each risk factor was calculated using multiple logistic regression. The prevalence of suicidal behaviours ranged from 0.7% (Myanmar) to 17.3% (Philippines) in 2007/2008, and from 8.6% (Indonesia) to 20.9% (Thailand) in 2015/2016. Being physically attacked or bullied and experiencing social difficulties were the most consistent and significant risk factors across countries and time points. Female gender, poverty, alcohol consumption, and drug use also contributed to risk at varying levels. Suicidal behaviours have risen alarmingly in several Southeast Asian countries. These findings suggest the urgent need for coordinated action by policymakers, health professionals, educators, and families to prevent adolescent suicidal behaviours.
This study aims to examine the different aspects of socio-economic status (SES) patterns in mental health from adolescence into adulthood by investigating the mean, prevalence, cumulative incidence and trajectories of several mental health measures, including depressive symptoms, mental disorder diagnosis and medication use. The different aspects of SES are investigated through the measures of subjective social status (SSS) in school, SSS in society, income and parental educational level.
Methods
Individuals born in 1989 were followed from 2004 to 2021 with surveys at ages 15, 18, 21, 28 and 32 years, supplied with yearly register data. The mean level of depressive symptoms, yearly prevalence of medication use and cumulative incidence of mental disorder diagnosis were calculated for each SES group (low, middle and high) across each measure. Group-Based Trajectory Modelling (GBTM) was used to identify depressive symptom trajectories and logistic regressions were used to analyse the relative odds ratios (ROR) of membership to the different trajectory groups by characteristics.
Results
Individuals with low SES at age 15 years across all SES measures showed higher mean depressive symptoms, prevalence of medication use and cumulative incidence of mental disorder diagnosis through adolescence and adulthood (age 15–32 years). Four depressive symptom trajectories were identified: low stable, moderate stable, decreasing and increasing trajectories. Being female, receiving medication or a mental disorder diagnosis in early adulthood and during the study period, having low SSS in school, parents not living together, being bullied, lacking support from teachers or classmates, lower levels of parents’ support or higher school pressure resulted in higher RORs of membership to the other trajectory groups compared to the low stable trajectory, while having high SSS in society resulted in a lower ROR.
Conclusions
This is the first study to detect the role of social support in relation to depressive symptom trajectories. While individuals with low social status consistently experienced more negative mental health outcomes than those with middle and high social status in the study period (age 15–32 years), low SSS showed the strongest associations. This indicates that SSS may capture vulnerable individuals not identified by traditional SES. Being female, having low SES, low social support, and other mental health outcomes were associated with higher odds of being in trajectories with more depressive symptoms. Preventive initiatives should therefore target individuals with such characteristics. It is worth exploring whether adolescents with increasing depressive symptoms could benefit from increased social support.
In recent times, several longitudinal studies aimed at clarifying whether cannabis use during adolescence might play a causal role in the subsequent risk of developing bipolar disorder have been published. Although their methodological heterogeneity precludes any meta-analytic approaches, evidence from these studies can be systematically evaluated using the Bradford Hill criteria. A biological gradient is supported by evidence on the dose–response relationship between exposure severity and outcome. As such, the effect of cannabis use on bipolar disorder onset is likely to be strong, coherent, plausible, and based on a clear temporality. In addition, some analogies can be hypothesized between studies testing the possible causal role of cannabis in the development of bipolar disorder and those is schizophrenia. Cannabis may represent a precipitating agent inducing bipolar disorder in a multicausal model of individual vulnerability. However, this relationship seems to be only partially consistent and nonspecific, and the experimental evidence is strongly suggestive but, as yet, inconclusive. Nevertheless, in summary, it seems there is sufficient support for the hypothesis that cannabis use during adolescence may play a causal role in bipolar disorder, although further studies are needed to consolidate the evidence.