Brief report: Explaining differences in depressive symptoms between African American and European American adolescents

African American adolescents report more depressive symptoms than their European American peers, but the reasons for these differences are poorly understood. This study examines whether risk factors in individual, family, school, and community domains explain these differences. African American and European American adolescents participating in the Birmingham Youth Violence Study (N = 594; mean age 13.2 years) reported on their depressive symptoms, pubertal development, aggressive and delinquent behavior, connectedness to school, witnessing violence, and poor parenting. Primary caregivers provided information on family income and their education level, marital status, and depression, and the adolescents' academic performance. African American adolescents reported more depressive symptoms than European American participants. Family socioeconomic factors reduced this difference by 29%; all risk factors reduced it by 88%. Adolescents' exposure to violence, antisocial behavior, and low school connectedness, as well as lower parental education and parenting quality, emerged as significant mediators of the group differences in depressive symptoms.     

Emotion regulation and depressive symptoms: Examining the mediation effects of school connectedness in Chinese late adolescents

This study tested Gross's process model of emotion regulation in a Chinese adolescent sample. It hypothesized that emotion regulation strategies (cognitive reappraisal and expressive suppression) would predict adolescents' perception of school connectedness and depressive symptoms. It also posited that school connectedness may be a possible mediator between emotion regulation and depressive symptoms. Participants were 504 adolescents aged 16–18 from two Chinese public upper secondary schools. Structural equation modeling analyses indicated that reappraisal and suppression significantly associated with school connectedness and depressive symptoms, and school connectedness mediated the link between emotion regulation and depressive symptoms, even when the general emotion experiences were controlled. Although boys unexpectedly reported higher level depressive symptoms, the hypothesized model was invariant across gender except for the link between suppression and depressive symptoms. These findings demonstrate that it is meaningful to involve both emotion regulation processes and school connectedness in explaining adolescent depressive symptoms.     

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.     

Suicidality and depression among african american adolescents: the role of family and peer support and community connectedness

Rates of suicide are increasing among African American adolescents and pose a significant public health concern. One area that has received little attention is the relationship between various types of social support and suicide, and the extent to which support moderates the relationship between depressive symptoms and suicidality. A total of 212 African American adolescents completed in-school surveys on three types of social support: family support, peer support, and community connectedness. The survey also addressed depressive symptoms and suicidality, as measured by reasons for living, a cognitive measure of suicide risk. Hierarchical multiple regression analyses were used to examine direct and moderating relationships between types of social support and suicidality. The results indicated that increased family support and peer support are associated with decreased suicidality, and peer support and community connectedness moderated the relationship between depressive symptoms and suicidality. Over a third of the variability in reasons for living was predicted by family support, peer support, and community connectedness. Implications for research and preventative interventions for African American adolescents are discussed.     

Exploring Psychosocial Mechanisms and Interactions: Links Between Adolescent Emotional Distress,School Connectedness,and Educational Achievement

Internalizing mental health issues are a significant developmental and clinical concern during adolescence, but rarely identified as a problem among school staff. Using data from the National Longitudinal Study of Adolescent Health, this study examined the associations between adolescent emotional distress, school connectedness, and educational achievement by exploring potential mechanistic and interactive roles of perceived school connectedness on the emotion–education association. Emotional distress was negatively associated with adolescents’ perceptions of belonging to school, which, in turn, may negatively influence educational achievement. School connectedness also had both additive and multiplicative interaction effects on the emotion–education relationship. Results support previous evidence of school connectedness as a protective factor for adolescents with internalizing mental health concerns, although much of the work to date has focused on externalizing problems. This study informs our understanding of how, why, and for whom emotional problems influence educational outcomes in light of social support in the school context.     

Mechanisms linking violence exposure and school engagement among african american adolescents: examining the roles of psychological problem behaviors and gender

This study examines whether the relationship between violence exposure and school engagement is mediated by psychological problem behaviors and whether such relationships are gendered. Five hundred and sixty-three high school African American adolescents (ages 13-19 years) completed questionnaires that assessed two types of violence exposure (community violence and marital conflict), psychological problem behaviors (e.g., posttraumatic stress disorder symptoms, anxiety, withdrawal, and aggressive behaviors), and school engagement (i.e., student-teacher connectedness and grade point average [GPA] obtained from school records). For male adolescents, psychological problem behaviors collectively mediated the relationship between community violence exposure and student-teacher connectedness. For female adolescents, both community violence and marital conflict exposure were negatively related to both GPA and student-teacher connectedness via aggressive behavior. Findings suggest that the differential impact of type of violence exposure and its sequela based on gender should be considered when addressing low school engagement among African American youth.     

Ethnic identity, self-esteem, and perceived efficacy as mediators of the relation of supportive parenting to psychosocial outcomes among urban adolescents

The present study examined the direct and indirect relationships among supportive parenting, ethnic identity, self-esteem, perceived efficacy, and psychological adjustment in an urban sample of 133 African American (M age=16.37) and 110 European American (M age=16.43) adolescents. Although the mediational model was partially supported for both African American and European American youth, the data better fit the model for the African American group. Specifically, perceived efficacy fully mediated the relation between ethnic identity and depressive symptoms, and partially mediated the relation between self-esteem and depressive symptoms for African American youth. For European Americans, self-esteem fully mediated the relation between supportive parenting and perceived efficacy. This study illustrates the importance of examining developmental models separately for adolescents from different ethnic/racial backgrounds.     

Depressive symptomatology, exposure to violence, and the role of social capital among African American adolescents

Focusing on the role of capital as both personal and social resources for adolescents, the authors examined depressive symptomatology among a sample of 10- to 18-year-old African American youths (N=1,538). In addition to gender and age differences, adolescents exposed to threatening environments (school, neighborhood, home) reported more depressive symptoms. Social capital had a significant inverse relationship with adolescent depression; self-esteem and a social capital index were negatively related to depressive symptomatology. Furthermore, the interaction effects of gender with social capital, age with self-esteem, and age with grades were significant, indicating the presence of a buffering effect. These findings suggest the importance of interrelationships among violence exposure, capital, and well-being for adolescents.     

The role of religious involvement on depression, risky behavior, and academic performance among Korean American adolescents

Structural equation modeling was used to test a theoretical path model of church engagement, personal spirituality, and mentoring relationships on depressive symptoms, involvement in risky behaviors, and self-reported grades among Korean American adolescents. It was hypothesized that personal spirituality and mentoring relationship quality would mediate the relation between church engagement and adolescent outcomes. Data were obtained through a self-report survey from 248 Korean American adolescents in grades 7 through 12. High levels of church engagement, as characterized by years of attendance, choice to attend, and participation in activities, predicted deeper personal spirituality and better mentoring relationships. Personal spirituality, as measured by one’s daily religious experiences, beliefs, and private spiritual practices, was a mediator of the relationship between church engagement and adolescent outcomes. Specifically, higher levels of church engagement was linked to stronger personal spirituality, which in turn predicted less depressive symptoms for girls and higher grades for boys.     

Concordance of reports of mental health functioning by adolescents and their caregivers: a comparison of European, African and Latino Americans

The purpose of this study was to examine the concordance of parental and adolescent reports of adolescents having emotional and behavioral problems. Data were collected from youths (age 11-17) and adult caregivers from a community-based sample of households. The sample consisted of 4175 youths and their caregivers (37.8% European, 35.0% African, 25.4% Latino, and 1.8% other American). Indicators of emotional and/or behavioral problems were global indicators: perceived mental health, life satisfaction, happiness, interpersonal problems at home, and problems at school. Overall, parent-child concordance on the indicators of mental health was low, with a mean kappa value of 0.12. In multivariate analyses, European American parent-youth dyads were significantly more likely to be concordant on reports of perceived mental health, problems at home, and problems at school than African American and Latino dyads. Our data suggest that ethnicity is a significant factor in parental labeling and awareness of adolescent mental health problems. Future research should examine whether the extent to which greater lack of concordance on the indicators of mental health by minority parent-child dyads plays a role in entry into and retention in mental health care.     

Associations between adolescent depression and parental mental health, before and after treatment of adolescent depression

The negative impacts of parental mental health problems on children and adolescents are well known, but the relationship between a child’s depression and their parents’ health is not so well understood. Being a carer/parent of someone with mental illness can be associated with negative outcomes for the caregiver. This paper reports the associations between the mental health of adolescents with major depression and their parents, before and after treatment of the adolescent’s depression. Data were collected as part of the Adolescent Depression Antidepressants and Psychotherapy Trial, a randomised controlled trial of selective serotonin reuptake inhibitors with and without cognitive behaviour therapy in 208 clinic-recruited adolescents with major depression. The baseline severity of depression in the adolescent was significantly associated with both maternal and paternal mental health (as rated by the General Health Questionnaire). This effect was not confounded by other psychiatric symptoms. The degree of improvement in parental and child mental health was positively correlated across time. Our results support the hypothesis that there is a significant association between parental mental health and adolescent depressive symptoms. This study was not able to establish the direction of this association. In clinical practice, the findings demonstrate the importance of considering the mental health of the parents when treating depressed adolescents.     

Predicting Mental Health Treatment Access Among Adolescents With Elevated Depressive Symptoms: Machine Learning Approaches

A large proportion of adolescents experiencing depression never access treatment. To increase access to effective mental health care, it is critical to understand factors associated with increased versus decreased odds of adolescent treatment access. This study used individual depression symptoms and sociodemographic variables to predict whether and where adolescents with depression accessed mental health treatments. We performed a pre-registered, secondary analysis of data from the 2017 National Survey of Drug Use and Health (NSDUH), a nationally representative sample of non-institutionalized civilians in the United States. Using four cross-validated random forest models, we predicted whether adolescents with elevated past-year depressive symptoms (N?=?1,671; ages 12–17 years) accessed specific mental health treatments in the previous 12 months (“yes/no” for inpatient, outpatient, school, any). 53.38% of adolescents with elevated depressive symptoms accessed treatment of any kind. Even with depressive symptoms and sociodemographic factors included as predictors, pre-registered random forests explained?<?0.00% of pseudo out-of-sample deviance in adolescent access to inpatient, outpatient, school, or overall treatments. Exploratory elastic net models explained 0.80–2.50% of pseudo out-of-sample deviance in adolescent treatment access across all four treatment types. Neither individual depressive symptoms nor any socioeconomic variables meaningfully predicted specific or overall mental health treatment access in adolescents with elevated past-year symptoms. This study highlights substantial limitations in our capacity to predict whether and where adolescents access mental health treatment and underscores the broader need for more accessible, scalable adolescent depression treatments.

     

School connectedness, peer attachment, and self-esteem as predictors of adolescent depression

Recent literature suggests that school connectedness (SC) may be a key determinant of adolescent mental health. Specifically, SC has been found to have a negative relationship with adolescent depression. In the current, cross sectional study, we examine whether the relationship between SC and symptoms of low mood is dampened or moderated by self-esteem (SE) and peer attachment style. Participants were 5022 adolescents (aged 11-16) who completed a battery of questionnaires in school, including measures of low mood, SC, SE, and peer attachment style. The relationship between SC and low mood was reduced by the inclusion of SE and peer attachment style. Peer attachment style was the largest predictor of low mood. The relationship between SC and low mood was not moderated by SE or peer attachment style. Interventions for adolescent depression may be most effective by focussing on increasing SE and fostering secure attachments, rather than solely focussing on increasing SC.     

Mental Health and School Functioning for Girls in the Child Welfare System: the Mediating Role of Future Orientation and School Engagement

This study investigated the association between mental health problems and academic and behavioral school functioning for adolescent girls in the child welfare system and determined whether school engagement and future orientation meditated the relationship. Participants were 231 girls aged between 12 and 19 who had been involved with the child welfare system. Results indicated that 39% of girls reported depressive symptoms in the clinical range and 54% reported posttraumatic symptoms in the clinical range. The most common school functioning problems reported were failing a class (41%) and physical fights with other students (35%). Participants reported a mean number of 1.7 school functioning problems. Higher levels of depression and PTSD were significantly associated with more school functioning problems. School engagement fully mediated the relationship between depression and school functioning and between PTSD and school functioning, both models controlling for age, race, and placement stability. Future orientation was not significantly associated with school functioning problems at the bivariate level. Findings suggest that school engagement is a potentially modifiable target for interventions aiming to ameliorate the negative influence of mental health problems on school functioning for adolescent girls with histories of abuse or neglect.     

Patterns of relationship and sexual behaviors in Mexican adolescents and associations with well-being: A latent class approach

To broaden our understanding of romance and sexuality during adolescence in Latin American countries, we used a person-oriented approach (latent class analysis) to examine classes marked by different patterns of romantic and sexual behaviors in Mexican adolescents. We found 5 classes: Inactive (8.53%), Early stage (37.8%), Waiting class (27.5%), Physical (8.4%) and Committed (17.9%); but no group dating class. We also explored how these classes were associated with adolescents' mental health and school performance. Middle school adolescents in the Committed class (high in romantic and sexual behaviors) had the highest level of depressive symptoms. Girls in the Inactive class and boys in the Physical class had the lowest level of symptoms. Adolescents in the Committed class also reported less academic motivation and achievement, whereas adolescents in the Inactive class reported higher motivation. This study expands our knowledge of adolescent romantic and sexual development in Mexico.     

The acting White accusation, racial identity, and anxiety in African American adolescents

Acting White is one of the most negative accusations an African American adolescent can receive from another. The accusation can either be made directly or indirectly. Research suggests that receiving the accusation may create distress for some African American adolescents. The current study examined the relationship between experiencing the acting White accusation, racial identity, and anxiety among African American adolescents. High school students completed the Multigroup Ethnic Identity Measure (MEIM), the Multidimensional Anxiety Scale for Children (MASC) and the Acting White Experiences Questionnaire (AWEQ). Results indicated that adolescents who both directly and indirectly experienced the AWA reported higher anxiety than those who only indirectly experienced the AWA. Additionally, adolescents who reported experiencing more indirect aspects of the accusation or being "bothered" more by the accusation reported higher levels of anxiety. Findings suggest that the acting White accusation may be a culturally relevant factor influencing anxiety among African American adolescents.     

Predictors of depressive symptoms in Chinese American college students: parent and peer attachment, college challenges and sense of coherence

Based on Antonovsky's salutogenic model, the authors hypothesized that sense of coherence would mediate the effects of parent and peer attachment and college challenges on depressive symptoms as well as moderate the relationship between college challenges and depressive symptoms in Chinese Americans. To test our hypotheses, 353 Chinese American college students completed paper-pencil measures. Supporting our hypotheses, sense of coherence fully mediated the effects of parent and peer attachment on depressive symptom level and served as a partial mediator and moderator of the effect of college challenges on depressive symptoms. Implications of the study findings for promoting the mental health of Chinese American students are discussed.     

Mental health and diurnal salivary cortisol patterns among African American and European American female dementia family caregivers.

Using a sociocultural stress and coping model, this pilot study examines the influence of depressive symptoms and stress on diurnal salivary cortisol patterns among African American (N=30) and European American (N=24) female dementia caregivers and noncaregivers (African American, N=48; European American, N=15). Caregiving participants completed the Center for Epidemiological Studies Depression Scale (CES-D), Perceived Stress Scale (PSS), and Stress-Related Growth Scale (SRGS) as respective measures of depressive symptoms, stress, and stress resilience. Participants also collected five saliva samples daily for two consecutive days. African American caregivers scored significantly higher than European American caregivers on the SRGS, but they did not differ on the PSS and CES-D scales. Regression analyses with age, ethnicity, caregiving status, and depressive symptoms as predictors, and cortisol slope as criterion, showed that only age and ethnicity predicted cortisol slope. African Americans had flatter slopes than the European Americans sampled, regardless of caregiving status. Findings highlight the role of cultural beliefs and of ethnicity in explaining cortisol function.     

Relations between mindfulness and mental health outcomes: need fulfillment as a mediator

Links between mindfulness and mental health outcomes have been established, but the explanatory mechanisms responsible for these associations are far less understood. This study examined relationships between mindfulness, need fulfillment and mental health outcomes (negative affect and depressive symptoms). The primary purpose of this paper was to, first, verify the link between mindfulness and mental health outcomes, and second, to better understand and explain why mindfulness is important for mental health outcomes. Specifically, this study sought to examine the potential mediating influence of need fulfillment in the relationship between mindfulness and mental health outcomes. A sample of 399 university students and employees responded to an online survey. Data were collected on personal ratings of trait mindfulness, need fulfillment, negative affect and depressive symptoms. Results indicated a significant positive relationship between mindfulness and need fulfillment, and these variables were negatively associated with poor mental health outcomes (negative affect and depressive symptoms). Further, it was found that need fulfillment partially mediated the relationship between mindfulness and both mental health outcomes. Specific facets of need fulfillment (i.e., belongingness, self-esteem, control, meaningful existence) were also explored individually as potential mediators to determine which facet accounted for the greatest variance in the relationship between mindfulness and mental health outcomes. In doing so, this study helps clarify the relations between mindfulness and mental health outcomes. Results from this study extend the current literature of mindfulness and further inform the implementation of clinical mindfulness techniques and strategies.     

Psychiatric disorder,impairment, and service use in rural African American and white youth

BACKGROUND: The Caring for Children in the Community Study examined the prevalence of DSM-IV psychiatric disorders and correlates of mental health service use in rural African American and white youth. METHODS: Four thousand five hundred youth aged 9 to 17 years from 4 North Carolina counties were randomly selected from school databases. Parents completed telephone questionnaires about their children's behavior problems. A second-stage sample of 1302 was identified for recruitment into the interview phase of the study, and 920 (70.7%) of these were successfully interviewed at home using the Child and Adolescent Psychiatric Assessment and related measures of service use. RESULTS: Weighted back to general population estimates, 21.1% of youth had 1 or more DSM-IV psychiatric disorders in the past 3 months. Prevalence was similar in African American (20.5%) and white (21.9%) youth. The only ethnic difference was an excess of depressive disorders in white youth (4.6% vs 1.4%). Thirteen percent of participants (36.0% of those with a diagnosis) received mental health care in the past 3 months. White youth were more likely than African American youth to use specialty mental health services (6.1% vs 3.2%), but services provided by schools showed very little ethnic disparity (8.6% vs 9.2%). The effect of children's symptoms on their parents was the strongest correlate of specialty mental health care. CONCLUSIONS: In this rural sample, African American and white youth were equally likely to have psychiatric disorders, but African Americans were less likely to use specialty mental health services. School services provided care to the largest number of youths of both ethnic groups.