Adolescent Research Review最新文献

There is a need for a comprehensive understanding of the relationship between adverse childhood experiences (ACEs) and the emergence of bullying behaviors in adolescence, as well as their subsequent implications for youth well-being. This study systematically reviewed the link between 11 unique ACEs (including the original 10 from the 1998 CDC-Kaiser ACE study plus child welfare involvement) and three specific bullying behaviors (i.e., perpetration, victimization, and bully-victim) over two decades (1999–2019). Five databases (i.e., Embase, ERIC, PsycINFO, PTSDpubs, and PubMed) were used to identify 51 studies. The findings showed a consistent pattern of positive associations for certain ACEs, specifically cumulative ACEs, maltreatment, family violence, physical abuse, and domestic violence, with bullying perpetration and victimization. However, sexual abuse and divorce and separation were not consistently related to perpetration or victimization. In addition, general abuse was positively associated with perpetration, whereas emotional abuse and children in the welfare system tended to be victims rather than perpetrators of bullying. Notably, several ACEs, including neglect and household dysfunction, remain largely understudied in relation to bullying. The research also predominantly focuses on bullying perpetration and victimization, with bully-victims receiving much less attention. Finally, the research on the impact of bullying behaviors on the well-being of youth with ACEs is too limited to make definitive conclusions regarding the mediating or moderating role of bullying on youth well-being outcomes. The results underscore the importance of understanding and accounting for the simultaneous and cumulative effects of ACEs. This understanding is essential when designing trauma-informed interventions and prevention strategies to combat bullying. Future longitudinal studies should rectify methodological and psychometric shortcomings, investigate potential mediators and moderators, and integrate health outcomes of positive experiences with adverse childhood experiences to capture shared risk and resilience pathways.

The literature to date has documented the presence of challenges and barriers in mental health systems and services for children and adolescents worldwide. However, studies addressing this reality often do so in a fragmented, residual, incomplete, or generalized way, therefore hindering a comprehensive understanding of this complex phenomenon. The aim of this qualitative systematic review is to analyze the barriers and challenges affecting global mental health care for children and adolescents. Searches were made in the Web of Science, Scopus, and PubMed databases between 2018 and 2022 using terms connected with mental health, childhood, adolescence, and health systems. The search resulted in the extraction of 9075 articles, of which 51 were considered eligible for inclusion and complied with quality indicators. A number of closely related structural, financial, attitudinal, and treatment barriers that limited the quality of life and well-being of children and adolescents with mental health needs were found. These barriers included inadequate public policies, operational deficiencies, insufficient insurance coverage, privatization of services, stigma, lack of mental health literacy, lack of training, overburdened care, dehumanization of care, and lack of community and integrated resources. The analysis of these barriers displays that this treatment gap reflects the historical injustice towards mental illness and the disregard for real needs in these crucial stages, perpetuating a systematic lack of protection for the mental health of children and adolescents. The complexity of the disorders and the absence of public resources have resulted in a hodgepodge of mental health services for children and adolescents that fails to provide the continuing specialist health care they need.

There is a need for a systematic understanding of how adverse childhood experiences (ACEs) affect peer relationships during adolescence and the subsequent effects on youth well-being. This study conducted a systematic literature review of the two decades (1999–2019) following the CDC-Kaiser ACE study (1998). The review included 11 ACEs (i.e., 10 ACEs from the CDC-Kaiser ACE study plus child welfare involvement) and searched five databases (i.e., Embase, ERIC, PsycINFO, PTSDpubs, and PubMed). Ninety-two studies were included. The findings indicated that ACEs were differentially associated with six aspects of peer relationships: (1) ACEs were negatively associated with peer relation quantity and peer status; (2) ACEs were not significantly related to peer support; (3) associations of ACEs with peer relationship quality and peer characteristics included negative and nonsignificant findings; and (4) relations between ACEs and peer influence appeared contradictory (i.e., positive and negative associations). Additionally, various aspects of peer relationships further affected the well-being of youth with ACEs. The findings call for more attention to the associations between ACEs and adolescent peer relationships. Longitudinal studies that examine change over time, potential mechanisms, and moderating factors in the associations between ACEs and peer relations are needed to clarify the heterogeneity of findings across the six aspects of peer relations. Lastly, the findings suggest a potential expansion of the trauma-informed care principle by considering multiple facets of peer relationships beyond peer support.

Despite the worrying prevalence of mental disorders among adolescents and young people, evidence on predictors of treatment outcome remains scarce. Systematic reviews have focused on specific disorders or treatment modalities and have not targeted this age group in particular. This systematic review presents an overview of the sociodemographic predictors and moderators on the outcome of psychotherapeutic interventions for adolescents and young people with mental disorders across treatment modalities. The search was conducted in PubMed and PsycINFO following the PICOS strategy. The included studies were clinical outcome studies on psychotherapeutic interventions, targeted for young people (aged 12–30 years) with specified mental disorders and published in peer-reviewed journals. During a four-step screening process, 17,359 articles were assessed, among which 114 met the inclusion criteria. Most included studies involved patients with mood, eating, or substance use disorders. Age, gender, and ethnicity were the most frequently reported predictors. For age and gender the findings were mixed, so it is not possible to state which age group or gender would benefit most from treatment across disorder groups. Ethnic minority status and history of traumatic events may predict poorer outcomes. However, the results mainly did not support the relevance of sociodemographic variables for predicting treatment outcome.

Researchers globally are testing the potential of economic empowerment interventions such as financial guidance, education savings accounts, and asset transfer to promote educational well-being. Yet limited evidence exists of these interventions’ quality and effectiveness in improving educational well-being outcomes such as school enrollment and academic achievement. This systematic review evaluates these interventions’ methodological strengths and weaknesses, describes common intervention components and outcomes measured, and assesses intervention effectiveness. Overall, 15 studies from Sub-Saharan Africa, North and Central America, Southeast Asia, and Europe were included in this review (age: 5–19 years). Over half of the intervention studies scored at/above the median (high rigor). Notable strengths include using experimental study designs, articulation of theoretical framework, longer follow-up periods, transparency about dropout/attrition rates, and the conduct of parallel intervention replications across multiple schools. Methodological weaknesses included not stating quality control measures and not reporting measurement validity and reliability. Overall, most interventions effectively improved educational well-being. Interventions were most effective at improving academic attendance/participation, performance, and achievement, and less effective in educational enrollment. As education is a key modifiable determinant of well-being, interventionists have a great opportunity to develop and implement tailored economic empowerment interventions to promote educational well-being.

Research has established associations between poor mental health and lifestyle risk behaviors among adolescents, yet gaps exist in understanding whether digital health interventions for adolescents targeting these behaviors will improve mental health and wellbeing. This study aimed to evaluate how effective digital health interventions targeting lifestyle risk behaviors are in improving mental health/wellbeing among adolescents (10–24 years old). We also aimed to understand how effects vary by participant and intervention characteristics, and intervention adherence and engagement. Through systematic review with meta-analysis, 5229 records were identified. 17 studies were included representing 9070 participants (15.3 mean age, 1.2 SD). Interventions had small but statistically non-significant positive effects on physical and psychosocial quality of life, depressive symptoms and anxiety at follow-up compared to usual care controls. Digital health delivery methods included text messaging, mobile applications, websites and email, or a combination of these. Intervention adherence, engagement and satisfaction were measured poorly across studies. Despite small changes, potential exists for digital health interventions to improve mental health or wellbeing outcomes among adolescents due to the shared nature of risk and protective factors for mental health and chronic diseases.

Digital interventions have emerged as a promising tool for preventing youth violence, although the evidence base supporting their effectiveness lacks a cohesive framework. The aim of this review was to consolidate existing strategies for preventing youth violence through technology, providing insights into the current landscape, emerging trends, gaps, and the effectiveness of these strategies. Several databases were searched for evaluation studies of digital interventions specifically designed for children and adolescents up to the age of 18, without imposing any restrictions on the publication dates (e.g., APA PsycArticles, APA PsycInfo). The methodological quality of the included studies was appraised using the Mixed Methods Appraisal Tool. The review covered 26 studies, which included a total of 24 distinct digital interventions targeting general aggression (N = 9), bullying and/or cyberbullying (N = 11), and violence in intimate partner relationships (N = 4). These interventions, encompassing interactive games, online activities, and video training, have shown promising potential in preventing youth violence by targeting essential skills such as conflict resolution, emotion regulation, knowledge and awareness, empathy, and self-efficacy. Key areas for the improvement of digital interventions in youth violence prevention involve conducting careful evaluations, refining strategies, and considering cultural factors during intervention design. Also, efforts must be prioritized to ensure their longevity and sustained accessibility.

A developing evidence base suggests that dramatherapy, a creative form of psychotherapy, is a useful treatment for child and adolescent emotional disorders. However, little is known regarding the therapeutic benefits (“active ingredients”) of this intervention. A systematic search and meta-synthesis of secondary qualitative data reflecting participants’ perceptions of active ingredients of dramatherapy for symptoms of emotional disorders (anxiety, depression and trauma-related stress) was conducted. Six analytical themes emerged from eight studies. Dramatherapy as a learning (1) and social (2) experience and dramatherapy as a positive intervention (3) which supports self-expression (4) and emotion regulation (5) were identified as active ingredients. The skill and professionalism of dramatherapists (6) were also identified. This study is limited as the data available were not collected for the primary purpose of identifying active ingredients, more focused investigations may reveal different findings. In addition, studies contributed unequal amounts of data thus, findings may be skewed. The findings of this synthesis were benchmarked against other interventions commonly offered to children and young people with emotional distress. Three active ingredients (dramatherapy is fun, dramatherapy builds confidence, participants process difficulties through drama) were deemed unique to dramatherapy. Further research could employ mediation analysis to determine therapeutic mechanisms of change of this intervention.

Typical school provision of physical education, physical activity and sports, which is reflective of the school’s response to the national curriculum, available resources and school ethos, may impact adolescent mental health and wellbeing. Systematic literature reviews have not yet considered this impact. The Web of Science, SPORTDiscus, PsychINFO, ERIC and MEDLINE databases were searched for relevant literature (2000–2022) pertaining to adolescents aged 12–18 years in secondary schools. Twenty studies met the inclusion criteria, including thirteen interventions, five cross-sectional and two longitudinal studies. Included studies contributed 108 reported effects, that examined depression, anxiety, self-esteem, self-efficacy, wellbeing, life satisfaction and positive mental health. Anxiety was the most frequently reported outcome, with 59% of the reported findings found to be non-significant, 24% significantly positive, 12% significantly negative and 6% reporting a negative trend but with no test of significance. Evidence supported the impact of physical education on adolescent mental health and wellbeing. Significantly positive effects were linked to interventions with minor modifications to typical provision such as the integration of teacher workshops and/or implementation of curriculum models. This suggests the importance of supplementing typical school provision of physical education to positively influence future impact.