Journal of Clinical Child and Adolescent Psychology最新文献

Objective: The coronavirus pandemic drastically increased social isolation. Autistic youth already experience elevated social isolation and loneliness, making them highly vulnerable to the impact of the pandemic. We examined trajectories of social disruption and loneliness in autistic and non-autistic youth during a six-month period of the pandemic (June 2020 until November 2020).

Method: Participants were 76 youth, ages 8 through 17, (M_age = 12.82, N_autistic = 51) with an IQ ≥ 70. Youth completed a biweekly measure of loneliness (Revised UCLA Loneliness Scale) and their parent completed a measure of pandemic-related family social disruption (Epidemic Pandemic Impacts Inventory).

Results: There were no time trends in loneliness across all youth, however, social disruption displayed linear, quadratic, and cubic trends. Non-autistic youth reported relatively greater declines in social disruption compared to autistic youth. Additionally, autistic youth reported relatively greater declines in loneliness relative to non-autistic youth. Greater social disruption was associated with higher loneliness, however, autistic youth demonstrated a relatively stronger relationship between social disruption and loneliness compared to non-autistic youth.

Conclusions: The current study was one of the first to investigate social disruption and loneliness in autistic youth during the COVID-19 pandemic. Results indicated that autistic youth experienced relative decreases in loneliness during this time, perhaps due to reductions in social demands. Nonetheless, when autistic youth did experience social disruption, they reported relatively higher levels of loneliness. This work contributes to our understanding of risk factors for loneliness and highlights the need to understand the benefits, as well as the challenges, to remote schooling and social interactions.

Objective: Children who have been exposed to a natural disaster in their lifetime comprise a significant population with specific risks and vulnerabilities, particularly for at-risk youth. The goal of the current study was to examine the role that severity of disaster exposure plays in determining the timing of alcohol and marijuana use initiation and the frequency of use four years later in a sample of at-risk, aggressive youth exposed to a devastating tornado. Of further interest was the examination of the moderating effect of temperamental fear and inhibitory control.

Method: Three hundred and forty-six youth (M_age = 11.33; 65% boys; 77.5% African-Americans, 18.3% Caucasian, 1.7% Hispanic) initially recruited for a prevention program for at-risk youth were followed for 4 years after a tornado. Cox PH regressions were conducted to predict timing of alcohol and marijuana use initiation. Zero-inflated negative binomial regressions were used to predict frequency of alcohol and marijuana use 4 years after the tornado.

Results: Disaster exposure severity was predictive of frequency of marijuana use four years after the tornado, but exposure alone was not predictive of initiation. Exposure severity predicted increases in risk for alcohol use initiation only for youth high in fear. Additionally, greater levels of inhibitory control protected youth from earlier alcohol use initiation.

Conclusions: Findings highlight a need to research the initiation and frequency of use for substances individually, while also assessing the needs of youth exposed to natural disasters with both their degree of disaster exposure and specific temperamental characteristics in mind.

Objective: This study examined the association between youth post-disaster stress responses and co-rumination in conversations with a parent several years after a devastating tornado.

Method: Adolescents (N = 200) drawn from an ongoing study for aggressive youth (ages 13 to 17; 80% African American) and their parents experienced an EF-4 tornado in 2011 and then provided joint recollections about their tornado experiences approximately 5 years later. Recollections were coded for the four components of co-rumination: rehashing problems, dwelling on negative affect, mutual encouragement of problem talk, and speculating about problems. Parent-rated post-traumatic stress symptoms (PTSS) and youth resting respiratory sinus arrhythmia (RSA) were measured approximately 6-months and 1-year post-tornado, respectively.

Results: Results indicated that co-rumination could be identified, and reliably measured, in the tornado conversations. Resting RSA moderated the association between post-disaster PTSS and the co-rumination component dwelling on negative affect, such that youth PTSS was associated with higher levels of dwelling on negative affect but only at lower levels of resting RSA (an index of physiological dysregulation). There was no association between youth PTSS and dwelling on negative affect at high resting RSA (an index of better physiological regulation). Youth PTSS and resting RSA were unrelated to the other three co-rumination components. No gender differences were found.

Conclusions: Results provide preliminary evidence establishing the co-rumination coding scheme in a sample of disaster-exposed parents and adolescents. Results also indicated that PTSS and resting RSA are important youth-level factors that relate to how parents and adolescents discuss their disaster experiences even years post-exposure.

Objective: Depression disparities between heterosexual youth and lesbian, gay, bisexual, queer, and other non-heterosexual (LGBQ+) youth are robust and linked to discrimination in schools. Advocacy by school-based Gender-Sexuality Alliances (GSAs) to raise awareness of LGBQ+ issues and to counteract discrimination may reduce these disparities within schools, yet has not been investigated schoolwide. We considered whether GSA advocacy over the school year moderated sexual orientation differences in depressive symptoms at the school year's end for students in the general school population (i.e., students who were not members of the GSA).

Method: Participants were 1,362 students (M_age = 15.68; 89% heterosexual; 52.6% female; 72.2% White) in 23 Massachusetts secondary schools with GSAs. Participants reported depressive symptoms at the beginning and end of the school year. Separately, GSA members and advisors reported their GSA's advocacy activities during the school year and other GSA characteristics.

Results: LGBQ+ youth reported higher depressive symptoms than heterosexual youth at the school year's beginning. However, after adjusting for initial depressive symptoms and multiple covariates, sexual orientation was a weaker predictor of depressive symptoms at the school year's end for youth in schools whose GSAs engaged in more advocacy. Depression disparities were significant in schools whose GSAs reported lower advocacy, but were statistically non-significant in schools whose GSAs reported higher advocacy.

Conclusion: Advocacy could be a means by which GSAs achieve school-wide impacts, benefiting LGBQ+ youth who are not GSA members. GSAs may therefore be a key resource for addressing the mental health needs of LGBQ+ youth.

Objective: Internalizing problems are common in adolescence and increased substantially during the COVID-19 pandemic. Although rates of anxiety and depression have since improved, the general increase in the prevalence of mental health problems and disruptions to mental health services during the COVID-19 pandemic has resulted in huge gaps in care. Although research has primarily focused on proximal correlates of internalizing problems, a growing literature suggests that factors outside youths' immediate microsystems are equally crucial for their mental well-being. Thus, it is important to investigate multisystemic correlates of internalizing problems to inform individual and community-based interventions to address the current mental health burden.

Method: Leveraging secondary data from a nationally diverse U.S. sample of 2,954 adolescents (ages 13-16), we examined the associations between factors at multiple levels of youths' ecologies - spanning indicators of threat and deprivation - and their depression and anxiety symptoms during the COVID-19 pandemic. Furthermore, in follow-up exploratory analyses, we examined if these associations differed by adolescents' racial/ethnic groups.

Results: Consistent with socioecological models, we found that indicators of threat and deprivation in the adolescents' immediate home and more distal neighborhood environments were associated with depression and anxiety symptoms. The patterns of associations were similar across racial/ethnic groups in multigroup structural equation models. Additionally, we found that mean levels of internalizing symptoms and socioecological predictors significantly differed across racial/ethnic groups.

Conclusion: These findings have important implications for understanding multi-level contributors to adolescent mental health, which may inform research, practice, and policy.

Objective: Ample evidence demonstrates that structural stigma - defined as societal-level conditions, cultural norms, and institutional policies and practices that constrain opportunities, resources, and well-being of stigmatized populations - is associated with psychopathology in adults from marginalized groups. Yet there is limited research on whether structural stigma is similarly associated with internalizing and externalizing symptoms among youth.

Method: Structural stigma related to sex, sexual orientation, race, and Latinx ethnicity was measured using indicators of state-level policy and aggregated attitudes. Using data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,414; M age = 12 years, SD = 0.66; 48% female, 6.8% lesbian, gay, and bisexual (LGB), 13.4% Black, 20% Latinx), we examined associations of structural stigma with internalizing and externalizing symptoms among female, LGB, Black, and Latinx youth.

Results: LGB youth living in higher (vs. lower) structural stigma states had elevated levels of internalizing and externalizing symptoms. In lower structural stigma states, there were no differences in externalizing symptoms between LGB and heterosexual youth. Similarly, Latinx youth and females living in higher (vs. lower) structural stigma states had elevated levels of externalizing symptoms. In lower structural stigma states, there were no differences in externalizing symptoms between Latinx youth and non-Latinx White youth. Structural stigma related to race was unrelated to internalizing or externalizing symptoms for Black youth.

Conclusions: This study provides novel evidence that macro-level social environments, in the form of structural stigma, contribute to adverse mental health outcomes for marginalized youth and partly explain disparities in externalizing symptoms.

Objective: Studies demonstrating associations between experiences of racism and traumatic stress symptoms have predominantly been conducted in adults, due in large part to the lack of available tools for assessing racism-based traumatic stress symptoms (RBTSS) in youth. This investigation sought to address this gap by developing and validating the first measure of RBTSS for ethnoracially minoritized adolescents.

Method: The Youth Racism-Based Traumatic Stress Symptom Scale (YRaBTSSS) was developed by drawing on relevant literature. Following iterative refinement based on feedback obtained via focus groups with adolescents, it was tested in two U.S. samples of 12-17-year-old ethnoracially minoritized adolescents (Study 1: n = 401, 50.6% female; Study 2: n = 651; 48.08% female) recruited through CloudResearch. Participants completed a demographic survey, the YRaBTSSS, and measures of trauma, racial/ethnic discrimination, and mental health.

Results: An exploratory factor analysis in Study 1 indicated that the YRaBTSSS is comprised of a single factor representing RBTSS. The final RBTSS scale had excellent internal consistency (α = 0.98) and significant factor loadings (0.72-0.87). The factor structure was replicated in Study 2. The YRaBTSSS demonstrated convergent validity through significant associations with related measures of PTSD symptoms (p < .001) and racial stress (p < .001). Finally, RBTSS were significantly associated with symptoms of anxiety (p < .01), depression (p < .01), and conduct problems (p < .05).

Conclusions: Findings show preliminary evidence for the reliability and validity of the YRaBTSSS. This measure presents new opportunities to investigate the effects of racism on ethnoracially minoritized adolescents from a traumatic stress perspective.

Objective: Anhedonia is a risk factor for suicidal thoughts. Treatment for anhedonia (behavioral activation) involves engaging in rewarding activities. Social media use is a rewarding activity for adolescents, and thus, a possible behavioral activation tool for adolescents experiencing anhedonia, reducing further symptom escalation (e.g. suicidal thoughts).

The current study tested: (1) Is momentary anhedonia negatively associated with looking forward to checking social media (predicted pleasure)? (2) Is momentary anhedonia associated with subsequently experiencing less positive mood on social media (actual pleasure)? (3) Are within-person changes in positive mood on social media (actual pleasure) associated with reduced likelihood of suicidal thoughts, and does this vary by levels of anhedonia?

Method: Sixty-two adolescents (M_age = 16.15 (0.97); 49.3% girls, 16.4% boys, 34.4% nonbinary; 40.3% white) completed ecological momentary assessments three times daily for eight weeks. All prompts asked about anhedonia, predicted pleasure from social media, and actual pleasure on social media. Evening prompts assessed daily suicidal thoughts. Multilevel models tested the above research questions.

Results: Adolescents experiencing momentary anhedonia above their average levels looked forward to checking social media less. However, more-than-usual momentary anhedonia was not associated with positive mood on social media (actual pleasure). Experiencing above-average positive mood on social media was associated with decreased probability of suicidal thoughts at the daily level. This relationship was not moderated by anhedonia.

Conclusion: For adolescents experiencing more-than-usual anhedonia, using social media for positive mood-boosting activities could be a behavioral activation tool and may be an important protective factor against suicidal thoughts.