Suicidal ideations and attempts among adolescents subjected to childhood sexual abuse and family conflict/violence: The mediating role of anger and depressed mood

Based on a sample of 9085 16- to 19-year-old students attending all high schools in Iceland in 2004, the current study examines depressed mood and anger as potential mediators between family conflict/violence and sexual abuse, on the one hand, and suicidal ideations and suicide attempts on the other. Agnew's general strain theory provides the theoretical framework for the study. Structural equation modelling (SEM) was conducted allowing explicit modelling of both direct and mediating effects using observed and latent variables. The findings showed that both depressed mood and anger mediated the relationship between family conflict/violence and sexual abuse and suicidal attempts. However, when testing the mediating pathways between sexual abuse and family conflict/violence and suicidal ideations, only depressed mood but not anger turned out to be a significant mediator. The authors discuss how these finding may inform and facilitate the design and development of interventions to reduce the likelihood of suicide attempts among young people.     

Depressed mood and drinking occasions across high school: Comparing the reciprocal causal structures of a panel of boys and girls

Does adolescent depressed mood portend increased or decreased drinking? Is frequent drinking positively or negatively associated with emotional well-being? Do the dynamic relations between depression and drinking differ by gender? Using block-recursive structural equation models, we explore the reciprocal short-term effects (within time, t) and the cross-lagged medium-term effects (t +1 year) and long-term effects (t + 2 years) of depressed mood and monthly drinking occasions. Data come from the high school waves of the Youth Development Study, a randomly selected panel of 1015 ninth graders followed to 12th grade. We found that for both genders, depressed mood consistently decreased short-term drinking in each grade measured. However, depression increased drinking for both genders in the medium-term but only for girls in the long-term. In the other direction, drinking tended to increase depression in the short-term only among ninth-grade boys and 12th-grade girls. Observed trends and differences in the magnitude of the reciprocal effects vary by gender, with drinking being especially deleterious to emotional well-being for boys early in high school (10th grade) but for girls on the cusp of the post-high school world (12th grade).     

Sleep and slow-wave activity in depressed adolescent boys: a preliminary study

ObjectiveAdolescence is a vulnerable period of life that is characterized by increasing incidence of depression. Sleep disturbance is one of the diagnostic symptoms of depressive disorder. Adolescence is also characterized by dramatic maturational changes in sleep and its regulation. The goal of this study was to assess sleep macroarchitecture and slow-wave activity (SWA) in depressed adolescent boys.MethodsEight non-medicated adolescent boys meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for depressive disorder and 10 age-matched healthy controls (average age 16.0 years) underwent polysomnography in their home environment for two consecutive nights. Sleep macroarchitecture, SWA, and SWA dissipation were assessed in all subjects.ResultsDepressed boys showed a flattened pattern of SWA dissipation through the night. SWA power was lower during the first non-rapid eye movement (NREM) episode in the frontal derivation and higher during the third NREM episode in the central derivation in the group of depressed boys as compared to healthy boys. The SWA dissipation pattern correlated with the severity of depressive symptoms, and the correlation was strongest in the frontal derivation. In addition, total sleep time was shorter in patients as compared to the control group, but no other differences were found in the macroarchitecture of sleep.ConclusionDepression in adolescent boys is characterized by more evenly distributed SWA through the night as compared to healthy subjects, and we showed for the first time that this pattern of SWA distribution is associated with severity of depressive symptoms. These findings suggest that homeostatic regulation of sleep may be impaired in adolescent depression.     

Buffering the effects of peer victimization on adolescent non-suicidal self-injury: The role of self-compassion and family cohesion

Non-suicidal self-injury (NSSI) is a significant behavioral problem among adolescents all over the world. This study examined the longitudinal relationship between peer victimization and NSSI, as well as the buffering effects of self-compassion and family cohesion on this relationship. Data were collected at two time points from 525 secondary school students (226 girls; M_age = 12.97, SD = 1.02) in China. Results showed that peer victimization (marginally) significantly predicted NSSI over time even after controlling for Wave 1 NSSI. This association was weakened under the condition of high levels of self-compassion. Findings of this study emphasize the buffering effect of self-compassion in the relationship between peer victimization and NSSI, and are informative for prevention and intervention of this behavioral problem.     

青少年抑郁症患者家庭环境因素的影响效应研究进展

本文目的是对青少年抑郁症患者家庭环境相关因素影响效应的研究进行综述。通过回顾国内外关于青少年抑郁症患者家庭环境方面的文献,从相关概念、评估方法、影响效应、影响机制等方面对研究进展进行阐述,并总结了其局限性和未来可能的研究方向,通过对抑郁症相关家庭负性环境的认识,为青少年抑郁症的早期识别和预防提供参考。     

Physical activity and onset of depression in adolescents: A prospective study in the general population cohort TRAILS

Although it has often been suggested that physical activity and depression are intertwined, only few studies have investigated whether specific aspects of physical activity predict the incidence of major depression in adolescents from the general population. Therefore the aim of this study was to investigate the effects of nature, frequency, duration and intensity of physical activity during early adolescence on the onset of a major depressive episode in early adulthood. In a population sample of adolescents (N = 1396), various aspects of physical activity were assessed at early adolescence (mean age 13.02, SD = 0.61). Major depressive episode onset was assessed using the Composite International Diagnostic Interview. A Cox regression model was performed to investigate whether physical activity characteristics and their interactions with gender predicted a major depressive episode onset up until mean age 18.5 (SD = 0.61). The individual characteristics of physical activity (nature, frequency, duration and intensity) or their interactions with gender did not predict a major depressive episode onset (p values >0.05). So far, there is no prospective evidence that physical activity protects against the development of adolescent depressive episodes in either boys or girls.     

The associations between body dissatisfaction,body figure,self-esteem,and depressed mood in adolescents in the United States and Korea: A moderated mediation analysis

The perception of one's body image becomes particularly important in adolescence. Body dissatisfaction has been associated with negative psychological functioning, such as self-esteem and depression. Previous findings showed that the decreased self-esteem due to body dissatisfaction explained the association between negative attitude toward body and psychological well-being in different cultural contexts. The present study examined adolescents from the US (N = 1002) and Korea (N = 3993) and replicated and extended the previous findings regarding body dissatisfaction and associated psychological outcomes. The results showed that body dissatisfaction predicted higher depressed mood and that self-esteem mediated this association for both American and Korean adolescents. Notably, the indirect effect of body dissatisfaction and perceived body image on depressed mood via self-esteem was greater for American adolescents than for Korean adolescents. The implications of the cultural difference in the significance of self-esteem in mediating the body dissatisfaction and depressed mood are discussed.     

Intergenerational discrepancies of parental control among Chinese American families: Links to family conflict and adolescent depressive symptoms

This study investigated how discrepancies between adolescents' and parents' endorsement of parental control contribute to adolescent depressive symptoms. Family conflict was hypothesized to mediate the link between parent-adolescent discrepancies and depressive symptoms. The sample consisted of 166 pairs of Chinese American adolescents and their parents. The results indicated that, as predicted, greater discrepancies between adolescents and their parents on parental control related to greater adolescent depressive symptoms. Furthermore, adolescent's perceived degree of family conflict partially mediated this relation. Both parents and adolescents are changing and adapting to their cultural contexts; some in synchrony and some not. Identifying areas where parents and adolescents diverge concerning values, behaviors, and beliefs, is an important avenue to understanding Chinese American adolescents' mental health.     

Cortisol and severe fatigue: a longitudinal study in adolescent girls

Fatigue is a common complaint among adolescents, especially in girls, and is associated with high rates of school absenteeism. Severe fatigue is often accompanied by psychological and physical symptoms. In the chronic fatigue syndrome (CFS) functioning of the hypothalamic-pituitary-adrenal (HPA)-axis has previously been found to be altered. The aim of the present study was to investigate whether cortisol production is deviant in fatigued adolescent girls from the general population and to study longitudinal changes in fatigue in association with possible changes in HPA-axis functioning. In the cross-sectional part of the study the cortisol response to awakening (CAR) and to a low-dose oral dexamethasone were examined in a group of fatigued adolescent girls (n=87) in comparison to a non-fatigued control group (n=77). Questionnaires regarding fatigue, depression, anxiety, sleep quality, somatic symptoms and CFS-related symptoms were filled out. Follow up measurements were performed after 6 and 12 months. While the fatigued and non-fatigued group differed remarkably on all symptom self-reports, no differences between groups in CAR and response to dexamethasone were observed. Girls in the fatigued group remained fatigued over time and reported high levels of other psychological and physical symptoms during the whole year of the study. The CAR varied between time points but correlated non-systematically with situational characteristics or symptom reports. We conclude that trait-like fatigue, as measured in a sample of adolescent girls from a high school population, is not reflected in a dysregulation as assessed on the level of salivary cortisol after awakening.     

Physical activity levels of adolescents with and without intellectual disabilities during physical education and recess

To compare physical activity levels in adolescents with and without intellectual disabilities during physical education and recess. Forty adolescents diagnosed with intellectual disabilities (inclusive classrooms, n = 20; self-contained classrooms, n = 20) and 40 age-matched typically developing peers (general classrooms) participated. All participants wore an Actigraph GT1M accelerometer for 5 consecutive weekdays during school hours. Three groups of adolescents were similarly active during physical education; however, adolescents with intellectual disabilities in self-contained classrooms were less active during recess than did the other two groups. In addition, they spent less percentage of time in moderate-to-vigorous physical activity during recess than did the typically developing adolescents. An inclusive, structured, and supportive environment promotes physical activity engagement in adolescents with intellectual disabilities.     

Physical activity during the segmented school day in adolescents with and without autism spectrum disorders

The purpose of this study was to assess the intensity of physical activity (PA) that secondary school-aged students with autism spectrum disorders (ASD) and typically developing (TD) students exert during a school day, and to compare the percentages of students achieving the recommended guidelines between groups. The PA of 60 male students (ASD, n = 30; TD, n = 30) was recorded every 10 s for up to 5 school days by performing uniaxial accelerometry. The main results are listed as follows: (a) daily PA was significantly lower among the students with ASD than among the TD students; (b) students with ASD spent significantly lower proportion of their time in moderate PA than TD students did during physical education (PE), recess, and lunchtime; and (c) fewer students with ASD than TD students achieved the PA guidelines during the school day and PE time. Schools should increase PA opportunities across the school day.     

Associations of physical activity with fatness and fitness in adolescents with Down syndrome: The UP&DOWN study

The aim of the present study was to examine the associations of objectively measured physical activity (PA) with several markers of fatness and fitness in a relatively large sample of adolescents with Down syndrome (DS). This study comprised a total of 100 adolescents with DS (37 females) aged 11–20 years-old, and a sex-matched sample of 100 adolescents without disabilities, participating in the UP&DOWN study. The ALPHA health-related fitness test battery for adolescents was used to assess fatness and fitness. PA was measured by accelerometry. Adolescents with DS had higher fatness and significantly lower fitness levels in all variables measured than adolescents without DS (all p < 0.05). Moderate-to-large effects were observed in fatness variables (d = 0.65–1.42), but particularly large values were found in fitness variables (d = 2.05–2.43). In addition, PA levels was not associated with fatness variables, whereas total PA and vigorous PA were associated with all fitness variables (p < 0.05), and moderate-vigorous PA (MVPA) was associated with muscular fitness (p < 0.05), after adjusting for potential confounders. Further analysis revealed that there were differences in fitness by tertiles of vigorous PA between the lowest and the highest groups in all fitness variables (all p < 0.05). However, no significant differences were found in fitness by tertiles of MVPA according with PA guidelines (≥60 min in MVPA). Our findings indicate that PA levels are not associated with fatness variables, whereas high PA levels, in particular vigorous PA, are positively associated with high fitness in adolescents with DS.     

Association between social isolation and inflammatory markers in depressed and non-depressed individuals: results from the MONICA/KORA study

Introduction

Depressed individuals not only suffer from chronic low grade inflammation, but also exhibit an inflammatory hyper-responsiveness to acute stress. We investigate whether chronic stress also induces an exaggerated inflammatory response in individuals with increased depression features. As model for chronic stress, social isolation was chosen.

Methods

Interleukin (IL)-6 and hs-CRP levels were assessed in 1547 subjects (847 men and 700 women), derived from the population-based MONICA/KORA study. Standardized questionnaires were used to assess depressed mood (depression and exhaustion subscale) and social isolation (social network index). The relationship between the two inflammatory markers, social isolation and depressed mood was examined taking into account interactions social isolation × depressed mood using multivariable linear regression models, adjusted for age, BMI, smoking, alcohol, and physical activity. Analyses were performed in men and women separately.

Results

We observed a significant interaction between depressed mood and social isolation regarding IL-6 and hs-CRP, respectively in men (p-value = 0.02 for IL-6 and <0.01 for hs-CRP), evidencing a substantial synergistic effect of social isolation, and depressed mood on inflammatory responses. Furthermore, depressed and socially isolated men had highly significantly elevated IL-6 levels (geometric mean: 3.76 vs. 1.92 pg/ml, p-value <0.01) and heightened hs-CRP levels (geometric mean: 2.01 vs. 1.39 mg/l, p = 0.08) in comparison with non-depressed and socially integrated men. In women, no significant associations were seen.

Conclusion

The interaction of depressed mood and social isolation elicits a substantial synergistic impact on inflammatory markers in men, but not in depressed women.     

Effects of physical activity on emotional well-being among older Australian women: cross-sectional and longitudinal analyses

OBJECTIVE: To explore relationships between physical activity and mental health cross-sectionally and longitudinally in a large cohort of older Australian women. METHOD: Women in their 70s participating in the Australian Longitudinal Study on Women's Health responded in 1996 (aged 70-75) and in 1999 (aged 73-78). Cross-sectional data were analyzed for 10,063 women and longitudinal data for 6472. Self-reports were used to categorize women into four categories of physical activity at each time point as well as to define four physical activity transition categories across the 3-year period. Outcome variables for the cross-sectional analyses were the mental health component score (MCS) and mental health subscales of the Medical Outcomes Study Short Form (SF-36). The longitudinal analyses focused on changes in these variables. Confounders included the physical health component scale (PCS) of the SF-36, marital status, body mass index (BMI) and life events. Adjustment for baseline scores was included for the longitudinal analyses. RESULTS: Cross-sectionally, higher levels of physical activity were associated with higher scores on all dependent variables, both with and without adjustment for confounders. Longitudinally, the effects were weaker, but women who had made a transition from some physical activity to none generally showed more negative changes in emotional well-being than those who had always been sedentary, while those who maintained or adopted physical activity had better outcomes. CONCLUSION: Physical activity is associated with emotional well-being among a population cohort of older women both cross-sectionally and longitudinally, supporting the need for the promotion of appropriate physical activity in this age group.     

Physical activity and neural correlates of aging: a combined TMS/fMRI study

Aerobic exercise has been suggested to ameliorate aging-related decline in humans. Recently, evidence has indicated chronological aging is associated with decreases in measures of interhemispheric inhibition during unimanual movements, but that such decreases may be mitigated by long-term physical fitness. The present study investigated measures of ipsilateral (right) primary motor cortex activity during right-hand movements using functional magnetic resonance imaging and transcranial magnetic stimulation (TMS). Healthy, right-handed participant groups were comprised of 12 sedentary older adults, 12 physically active older adults, and 12 young adults. Active older adults and younger adults evidenced longer ipsilateral silent periods (iSP) and less positive BOLD of ipsilateral motor cortex (iM1) as compared to sedentary older adults. Across groups, duration of iSP from TMS was inversely correlated with BOLD activity in iM1 during unimanual movement. These findings suggest that increased physical activity may have a role in decreasing aging-related losses of interhemispheric inhibition.     

系统家庭治疗前后精神障碍患者家庭动力学变化及其与疗效的 …

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Glucocorticoid sensitivity of immune cells in severely fatigued adolescent girls: a longitudinal study

Fatigue during adolescence is associated with somatic and psychological complaints that resemble the pattern of symptoms described for chronic fatigue syndrome (CFS). Studies in CFS and other stress-related syndromes suggested a dysfunction of the interactions between the hypothalamic-pituitary-adrenal axis (HPA-axis) and the immune system, i.e. a changed glucocorticoid (GC) receptor sensitivity of immune cells, to exist. Here we investigated whether severely fatigued girls from a healthy population have altered cortisol production and immune cell sensitivity for the synthetic GC, dexamethasone (DEX). In a longitudinal design, we examined ex vivo DEX sensitivity of monocytes and of T-cell mitogen-induced responses of severely fatigued (N=65) and non-fatigued girls (N=60). Fatigued girls reported more severe comorbid complaints than non-fatigued participants across three measurements during 1 year (T1: spring, T2: autumn, T3: spring) and had higher plasma cortisol levels throughout the study. DEX sensitivity of T-cell mitogen-induced responses showed seasonal variation with increased sensitivity in autumn compared to spring. No systematic variation of monocyte glucocorticoid receptor (GR) sensitivity was observed. Significant rank correlations of DEX sensitivity of T-cell mitogen-induced responses between the three assessments during the year suggest a stable trait of immune function. Groups did not differ in DEX sensitivity on any of the read outs. However, in a persistently fatigued subgroup, sensitivity to DEX was significantly reduced on the level of interferon (IFN)-gamma production. These results show that although fatigued participants had severe (comorbid) complaints, only in the case when symptoms persisted, altered GC sensitivity of immune cells was observed.     

Investigating the impact of masculinity on the relationship between anxiety specific mental health literacy and mental health help-seeking in adolescent males

BackgroundPoor mental health literacy and greater alignment with norms of hegemonic masculinity are established barriers to mental health help-seeking in men. However, little is known about how these variables influence adolescent male help-seeking and in particular, help-seeking for anxiety disorders. This study investigated the relationship between i) anxiety mental health literacy, ii) alignment with traditional masculinity norms and iii) help-seeking attitudes, intentions and behaviour in a sample of adolescent males.Methods1732 adolescent males (aged 12–18 years) participated online whilst at school.ResultsParticipant attitudes towards formal help-seeking, intentions to seek help from a family member and from an online source were found to predict professional help-seeking behaviour by the adolescent and/or by their parents on the adolescents’ behalf. In adolescents with a low or average personal alignment with norms of hegemonic masculinity, greater anxiety mental health literacy was positively associated with more favourable attitudes towards formal and informal help-seeking. However, this relationship was not found in adolescent males with a greater alignment with norms of hegemonic masculinity.LimitationsThe study had a correlational research design and used self-report measures.ConclusionsMental health initiatives which consider the impact of masculinity and gender stereotypes have the potential to significantly improve help-seeking in this population.     

The health diagnoses of homeless adolescents: A systematic review of the literature

Background

Homelessness during adolescence impacts negatively upon young people's physical and mental wellbeing. To be effective, programs aimed at addressing the health needs of this population must include knowledge of both the presenting and underlying acute and chronic conditions that characterise this high risk group of youth.

Methods

We undertook a systematic review of the international literature for studies that used validated instruments and techniques to diagnose prevalence rates of physical and mental health disorders in homeless adolescents.

Results

Twenty-one studies fulfilled the selection criteria. Of these, nine studies examined mental health diagnoses including depression, post-traumatic stress disorder, anxiety and substance abuse disorders. With one exception, the remaining twelve studies all related to sexually transmitted infections.

Conclusion

Homeless adolescents are diagnosed with widely varying rates of mental health disorders and high rates of sexually transmitted infection. Other likely chronic and acute physical conditions appear to be neglected in the published research.     

Testosterone levels and sexual maturation predict substance use disorders in adolescent boys: a prospective study.

BACKGROUND: This investigation determined whether testosterone level and sexual maturation in boys biased development of socially nonnormative behavior culminating in a substance use disorder (SUD). METHODS: The subjects were 179 boys recruited in late childhood through a high-risk paradigm. Path analysis was used to evaluate the influence of testosterone level and sexual maturation in early adolescence (age 12-14) on attitudes toward antisociality, affiliation with deviant peers, and social potency in middle adolescence (age 16), illicit drug use by late adolescence (age 19), and SUD in young adulthood (age 22). RESULTS: Testosterone level predicted social potency and approval of aggressive/antisocial behavior. Sexual maturation mediated the relation between testosterone level in early adolescence and later affiliation with deviant peers. Social potency, approval of aggressive/antisocial behavior, and deviant peer affiliations predicted illicit drug use by late adolescence that in turn predicted SUD in young adulthood. CONCLUSIONS: This study demonstrated that pubertal processes in early adolescence influence the risk for SUD via effects on psychosocial functioning.