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Objective

Exposure to stress is a risk factor for the development of psychopathology in adolescence. Coping and emotion regulation (ER) mediate and moderate the association between stress exposure and psychopathology, and interventions that teach coping and ER skills to adolescents have demonstrated efficacy for the prevention of psychological symptoms and disorders. Although multiple barriers limit the impact of in-person interventions, digital solutions are promising for delivering interventions in part or whole.

Method

The purpose of the current review is to inform the development of interventions that both work and impact public health. The focus is leveraging technology for the prevention of internalizing and externalizing psychopathology in adolescents, with coping and ER as the mechanisms for change.

Results

A brief overview of the research on coping and ER is provided; extant in-person and digital interventions targeting coping and ER to prevent psychopathology in adolescents are discussed; and a direction for how the field can progress to bridge the gap between research and commercial silos is provided.

Conclusion

Taken together, this review can guide efforts toward technology-based and -enhanced preventive interventions targeting coping and ER to prevent psychopathology in adolescents.

Diversity & Inclusion Statement

We actively worked to promote sex and gender balance in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list.

Objective

There has been little to no qualitative research done with adolescents and young adults (AYA) with type 2 diabetes (T2D) that can guide creation of interventions for this demographic. Using qualitative research methods, a novel mind–body intervention called Intervention for Early Onset Type 2 Diabetes (INTEND) has been developed for AYA aged 15 to 20 years, with the goal of improving self-management and coping skills, by enhancing routine care with augmented education coupled with mind–body skills.

Method

Qualitative interviews with AYA 15 to 20 years of age with T2D, their parents, and professionals caring specifically for this population were done through a focus group model. Transcripts were created, depersonalized, and coded using a Consensual Qualitative Research (CQR) method. Identified themes then guided the creation of course materials that included education about self-management of T2D and how to use the 4 mind–body technique toward self-care and regulation.

Results

The qualitative approach used in the development of this intervention revealed important findings in understanding key barriers faced by this group, key facilitators that improve their quality of life, and core components of an intervention that would be acceptable to them.

Conclusion

Results of this qualitative study helped craft an intervention tool that can subsequently be deployed and evaluated for effectiveness. Findings of the qualitative research model allow us to better understand the lived experience of AYA living with T2D.

Plain language summary

Youth-onset type 2 diabetes is a growing epidemic associated with increased risk for mental health problems, but there is little research regarding tailored treatment options. This study examined data from key stakeholder input from 3 patients, 3 parents, and 6 healthcare professionals using focus groups and qualitative interviews, to identify themes that guided the development of a novel mind-body intervention. Adolescents, medical providers and guardians identified stigma, isolation, and difficulty coordinating medical care as barriers to care. The novel mind-body intervention addressing both physical and mental health was positively received by all stakeholders. Thess results indicate the acceptability of a novel treatment for this understudied and underserved population.

Clinical guidance

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  Stigma of type 2 diabetes in adolescents may interfere with patients’ ability to adequately adhere to treatment recommendations

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  Clinicians need to identify social supports for adolescents with type 2 diabetes

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  Identifying family members and including them in treatment plans may help adolescents with type 2 diabetes

Objective

Being among the youngest in a school class increases the risk for worse educational outcomes and attention-deficit/hyperactivity disorder (ADHD) symptoms, but questions remain about the nature and persistence of such effects. We investigated this “relative age effect” on educational achievement at age 15 to 16 years and on ADHD symptoms from age 7 to age 21 years. Furthermore, we examined whether being young-in-class is linked to a greater reduction in ADHD symptoms from childhood to adulthood and a lower genetic propensity to ADHD.

Method

We identified 3,928 young-in-class and 4,580 old-in-class participants from the Twins’ Early Development Study. Educational achievement was measured with mathematics and English examination grades at age 15 to 16 years, and ADHD symptoms were measured using 2 different scales and different raters, from age 7 to 21 years, with effects tested using regression.

Results

A relative age effect emerged for English but not mathematics examination grades, and for the majority of parent and teacher ratings on ADHD symptoms, most consistently in middle childhood. Being young-in-class was associated with a greater reduction in parent-rated ADHD symptoms from childhood to adulthood when measured with a brief scale, but the comparable result from a longer scale was non-significant (after multiple testing correction). No interaction emerged between relative age and ADHD polygenic scores.

Conclusion

Our results emphasise the need to improve support for the children who start school younger than most, and to ensure that developmental comparisons take children’s precise age into account. Future research would benefit from in-depth analyses of individual trajectories and their variability among the young-in-class children.

Plain language summary

Young-in-class children are at increased risk for worse educational outcomes and attention-deficit/hyperactivity disorder (ADHD) symptoms, but their persistence is unclear. This study examined data from a large longitudinal UK community sample (3,928 young-in-class and 4,580 old-in-class) to identify age effects on educational achievements and ADHD symptoms. Results showed that young-in-class children are more likely to be rated with ADHD symptoms by both parents and teachers, especially in middle childhood, and have lower English exam grades at age 15 to 16.These results emphasize the need to improve support for children who start school younger than most and ensure that developmental comparisons take children’s precise age into account.

Objective

Metabolic syndrome is a serious and costly health condition that is increasingly prevalent in the United States. Current treatment standards, which include lifestyle modification and medication, do not consistently yield sustainable improvements. High rates of co-occurrence with psychiatric disorders suggest that understanding psychological factors associated with metabolic syndrome may be important for enhancing interventions. The current study examines the relations between the psychological construct of “dysregulation” and metabolic risk in children, adolescents, and adults.

Method

Participants were 95 family triads comprising 158 youth aged 7 to 17 years and 127 biological parents. Dysregulation was measured using a bifactor model comprising symptoms from the Anxious/Depressed, Attention Problems, and Aggressive Behavior subscales of the Child Behavior Checklist and Adult Self Report for children and adults, respectively. Metabolic risk was measured using confirmatory factor analysis, which included waist circumference, mean arterial pressure, insulin resistance, and triglyceride-to-HDL ratio.

Results

Higher levels of dysregulation were associated with increased metabolic risk in adults. In children, this association was moderated by age, such that dysregulation and metabolic risk were positively associated only for older youth.

Conclusion

The findings of this study suggest that the association between dysregulation and metabolic risk may become stronger with age and development. This highlights that early detection and intervention of dysregulation may help prevent metabolic comorbidities later in life.

Plain language summary

Psychiatric disorders frequently co-occur with metabolic syndrome. Understanding psychological factors associated with metabolic syndrome may help enhance interventions for both conditions. This study examined the relation between the psychological construct of “dysregulation” and metabolic risk in 95 families. Results showed that higher levels of dysregulation were associated with increased metabolic risk in both adults and their children. Dysregulation was positively associated with metabolic risk but only for older youth. Early identification and intervention of dysregulation may help prevent metabolic comorbidities later in life.

Objective

Stressors from the COVID-19 pandemic and limited availability of mental health care services have negatively impacted youth mental health in a significant way. In the first year of the pandemic, global prevalence of anxiety and depression increased by roughly 25% in pediatric populations. While the general trend is clear, this research aimed to explore the added mental health burden of acute COVID-19 on pediatric patients with chronic conditions and describe the differences in mental health outcomes between pediatric patients with 2 common chronic conditions (asthma and diabetes) to better understand specific factors that may increase susceptibility to mental health concerns.

Method

Using the TriNetX database, data were extracted for all pediatric patients (aged 5-17 years) with a positive SARS-CoV-2 infection (COVID-19) within a 1-year time frame (April 7, 2021, to April 6, 2022). These patients were divided into 4 cohorts based on the presence of chronic conditions before COVID-19 infection: diabetes (n = 1,587), asthma (n = 13,217), diabetes plus asthma (n = 626), and neither diabetes nor asthma (n = 104,427). For all cohorts, patients with other chronic illness and previous mental health diagnoses were excluded using relevant ICD-10 codes. After matching for demographics, comorbid conditions, and body mass index, odds ratios (ORs) of the following outcomes were compared between cohorts after 6 months: new psychiatric diagnosis using relevant ICD-10 codes, hospitalization within 1 week, and mortality.

Results

After matching, there were statistically significant differences in outcomes between patients with chronic illness and healthy controls after 6 months. Compared with healthy controls, the asthma cohort OR of developing a new psychiatric diagnosis was 1.4 (95% CI 1.15-1.71, p < .001), and the diabetes cohort OR was 1.81 (95% CI 1.11-2.94, p = .015). The new psychiatric diagnosis OR of the asthma cohort compared with the diabetes cohort was 0.62 (95% CI 0.39-0.99, p = .045), suggesting that patients in the diabetes cohort were particularly susceptible to additional mental health diagnoses after an acute COVID-19 infection.

Conclusion

Compared with healthy controls, pediatric patients with asthma and pediatric patients with diabetes experienced increased odds of developing a new psychiatric diagnosis after an acute COVID-19 infection.

Plain language summary

Adverse mental health outcomes have been reported in adults after a COVID-19 infection, but its effect on children with pre-existing chronic conditions is unclear. This study examined data from the TriNetX database, focusing on 5-to-17 year-old SARS-CoV-2 patients with pre-existing chronic conditions and without mental health diagnoses prior to infection, to identify factors associated with increased risk of mental he