IMPORTANCE: The American Academy of Pediatrics recommends that all families use a family media use plan to select and engage with media rules. To date, the effectiveness of this tool in promoting ...adolescent media rule engagement is unknown. OBJECTIVE: To test the effect of a family media use plan on media rule engagement in adolescents. DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial with parallel design used the online Qualtrics platform for recruitment, data collection, and intervention delivery. Parents and their children (aged 12 to 17 years) who spoke and read in the English language were recruited, enrolled, and randomized to either the intervention or control group. Parent-adolescent dyads in both groups completed baseline surveys individually, and the dyads in the intervention group completed the family media use plan survey. Baseline recruitment was conducted from April 8, 2019, to May 1, 2019, and follow-up surveys were completed between June 11, 2019, and July 2, 2019. INTERVENTIONS: The American Academy of Pediatrics family media use plan. MAIN OUTCOMES AND MEASURES: The primary outcome was media rule engagement reported by adolescents. Media rules were extracted from the family media use plan, and adolescents rated each rule (using Likert scales) according to whether the rule was present or followed in their home. Secondary outcomes were adolescent-perceived technology importance and changes in sleep, physical activity, and depression. RESULTS: A total of 1520 parent-adolescent dyads were enrolled in the trial and randomized to either the intervention or control group. Adolescents had a mean (SD) age of 14.5 (1.6) years, and 789 were female (51.9%) and 1027 were White (67.6%) individuals. Parents had a mean (SD) age of 44.1 (8.5) years, and 995 were women (65.5%) and 1021 were White individuals (67.2%). For media rule engagement, the between-group difference was –0.1 (95% CI, –1.1 to 0.9). CONCLUSIONS AND RELEVANCE: This randomized clinical trial found that completing a family media use plan did not lead to statistically significant changes in media rule engagement for adolescents in the intervention group. Future studies should consider revising the family media use plan and exploring the importance of technology as an intervention outcome. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03881397
A growing body of research indicates that phubbing can negatively influence adolescent development, it is not clear how perceived parental phubbing, adolescent phubbing, and adolescents’ adjustment ...problems concurrently relate to each other at the dimension level. This study conducted the contemporaneous network analyses and cross-lagged network analysis to examine the distinct relationships between the various dimensions of perceived father phubbing, perceived mother phubbing, adolescent phubbing and adolescent’s adjustment problems. A total of 1447 Chinese students (60.5% females; Mean age = 16.15,
SD
= 0.65) completed a survey at two-time points. The results of the contemporaneous network analyses indicated that perceived father/mother ignorance have the strongest links with the dimensions of adolescent phubbing and adolescents’ adjustment problems, suggesting that adolescents who reported high levels of perceived father/mother ignorance are more likely to concurrently face other issues and thus should be a primary focus of concern. The cross-lagged panel network analysis revealed that academic burnout is the primary catalyst in this dynamic network, which underscores a child-driven effect within the network. This emphasizes the importance of addressing adolescent academic burnout as a pivotal intervention point, both to alleviate phubbing in parent-adolescent interactions and to tackle adolescents’ adjustment problems.
This is the first study to examine the pathways from environmental stressors to substance use among a sample of South African adolescents (
N = 2195). The study objective was to assess how ...environmental stressors might affect cigarette smoking and alcohol use among South African adolescents, and to focus on one mechanism, low well-being, which might mediate this association. Participants consisted of 2195 Black, mixed ancestry ("Colored"), Indian, and White youth, aged 12–17 years old (mean age = 14.6; SD = 1.8), recruited via a multi-stage stratified sampling procedure in Durban, Cape Town, and Johannesburg, South Africa. Data were collected via individual in-person structured interviews, administered by trained interviewers in the participant’s preferred language. Structural equation modeling was used to analyze the interrelationships of environmental stressors (violent victimisation, legal and illegal drug availability) and low well-being (depressive symptoms, low self-esteem, health problems) with respect to adolescent cigarette smoking and alcohol use. The results supported our hypotheses: Environmental stressors were related to low well-being which, in turn, was linked to both adolescent smoking and alcohol use. There were also direct pathways from environmental stressors to both adolescent smoking and alcohol use. Smoking and alcohol use were significantly correlated. The findings suggest that environmental stressors may be associated with diminished psychological and physical well-being, as well as smoking and alcohol use, among South African adolescents. Longitudinal research is warranted to further understand the interrelationship of environmental stressors, low well-being, and adolescent substance use, so that these issues may be addressed by South African programmes and policies.
► First examination of the pathways from environmental stressors to smoking and alcohol use among South African adolescents. ► Environmental stressors were associated with both adolescent smoking and adolescent alcohol use. ► Low (psychological and physical) well-being among South African adolescents also was related to substance use. ► Diminished well-being may partially mediate the link between environmental stressors and adolescent tobacco and alcohol use. ► Longitudinal research is warranted to inform programmes and policy about the effect of environmental stressors, and low well-being, on adolescent substance use.
Adolescents make more reckless decisions when with peers than when alone, which poses a challenge for organizations that place adolescents in situations in which risky and myopic decision making is ...problematic. We asked whether the effect of peers on adolescents' decision making is mitigated by the presence of a slightly older adult. We examined whether target subjects' risk taking was greater when they were in groups of 4 late-adolescent males (ages 18–22) than when they were in groups that mixed 3 late-adolescent males with 1 slightly older adult (age 25–30); risk taking in both of these conditions was compared with that of adolescents tested alone. We found that adolescents took more risks and expressed stronger preference for immediate rewards when they were grouped with 3 same-age peers than when they were alone. When 1 adolescent was replaced by someone slightly older, however, adolescents' decision making and reward processing resembled that seen when adolescents were tested alone. Adding a young adult to a work team of adolescents may improve group decision making.
Understanding the burden and determinants of suicide during adolescence is key to achieving global health goals. We examined the prevalence and determinants of self-reported suicidal ideation and ...attempts among younger (13-15 years) and older adolescents (16-17 years).
Pooled prevalence estimates with 95% confidence interval, were calculated for suicide ideation and attempts for 118 surveys from 90 countries that administered the Global School-based Student Health Survey (GSHS) to adolescents (13-17 years of age) from 2003 to 2017. Indicators (including individual and social factors) associated with suicidal ideation and attempts were determined from multivariable linear regressions on key outcomes.
The prevalence of suicidal ideation representing 397,299 adolescents (51.3% female) was significantly higher among girls than boys whereas attempts did not differ by age or sex. Being bullied, or having no close friends was associated with suicidal ideation among girls 13-15 years and 16-17 years, respectively. Among all boys, being in a fight and having no close friends was associated with suicidal ideation with the addition of serious injury for boys 13-15 years. Common to all younger adolescents was an association of suicide attempt with being bullied and having had a serious injury. Among young boys, having no close friends was an additional indicator for suicide attempt. Having no close friends was associated with suicide attempt in older adolescents with the addition to being bullied in older girls and serious injury in older boys.
Building positive social relationships with peers and avoiding serious injury appear key to suicide prevention strategies for vulnerable adolescents. Targeted programs by age group and sex for such indicators could improve mental health during adolescence in low and middle-income countries, given the diverse risk profiles for suicidal ideation and attempts.
Recent research shows an increased concern with well-being at school and potential problems associated with students’ use of socio-digital technologies, i.e., the mobile devices, computers, social ...media, and the Internet. Simultaneously with supporting creative social activities, socio-digital participation may also lead to compulsive and addictive behavioral patterns affecting both general and school-related mental health problems. Using two longitudinal data waves gathered among 1702 (53 % female) early (age 12–14) and 1636 (64 % female) late (age 16–18) Finnish adolescents, we examined cross-lagged paths between excessive internet use, school engagement and burnout, and depressive symptoms. Structural equation modeling revealed reciprocal cross-lagged paths between excessive internet use and school burnout among both adolescent groups: school burnout predicted later excessive internet use and excessive internet use predicted later school burnout. Reciprocal paths between school burnout and depressive symptoms were also found. Girls typically suffered more than boys from depressive symptoms and, in late adolescence, school burnout. Boys, in turn, more typically suffered from excessive internet use. These results show that, among adolescents, excessive internet use can be a cause of school burnout that can later spill over to depressive symptoms.
Adolescents exposed to domestic violence are at high risk for dating abuse. This randomized controlled trial evaluated a dating abuse prevention program designed specifically for this risk group.
...Moms and Teens for Safe Dates
consisted of six mailed booklets of dating abuse prevention information and interactive activities. Mothers who had been victims of domestic violence but no longer lived with the abuser delivered the program to their adolescents who had been exposed to the abuse. Mother and adolescent pairs (N = 409) were recruited through community advertising; the adolescents ranged from 12 to 16 years old and 64 % were female. Mothers and adolescents completed baseline and 6-month follow-up telephone interviews. Booklet completion in the treatment group ranged from 80 % for the first to 62 % for the last booklet. The analyses first tested whether program effects on dating abuse varied by four a priori identified moderators (mother’s psychological health, the amount of adolescent exposure to domestic violence, and adolescent sex and race/ethnicity). Main effects of the program were examined when there were no differential program effects. Program effects on psychological and physical victimization and psychological and cyber perpetration were moderated by the amount of adolescent exposure to domestic violence; there were significant favorable program effects for adolescents with higher, but not lower levels of exposure to domestic violence. There were no moderated or main effects on sexual violence victimization and perpetration or cyber victimization. The findings suggest that a dating abuse prevention program designed for adolescents exposed to domestic violence can have important positive effects.
Background: Conduct disorder (CD) in female adolescents is associated with a range of negative outcomes, including teenage pregnancy and antisocial personality disorder. Although recent studies have ...documented changes in brain structure and function in male adolescents with CD, there have been no neuroimaging studies of female adolescents with CD. Our primary objective was to investigate whether female adolescents with CD show changes in grey matter volume. Our secondary aim was to assess for sex differences in the relationship between CD and brain structure.
Methods: Female adolescents with CD (n = 22) and healthy control participants matched in age, performance IQ and handedness (n = 20) underwent structural magnetic resonance imaging. Group comparisons of grey matter volume were performed using voxel‐based morphometry. We also tested for sex differences using archive data obtained from male CD and control participants.
Results: Female adolescents with CD showed reduced bilateral anterior insula and right striatal grey matter volumes compared with healthy controls. Aggressive CD symptoms were negatively correlated with right dorsolateral prefrontal cortex volume, whereas callous‐unemotional traits were positively correlated with bilateral orbitofrontal cortex volume. The sex differences analyses revealed a main effect of diagnosis on right amygdala volume (reflecting reduced amygdala volume in the combined CD group relative to controls) and sex‐by‐diagnosis interactions in bilateral anterior insula.
Conclusions: We observed structural abnormalities in brain regions involved in emotion processing, reward and empathy in female adolescents with CD, which broadly overlap with those reported in previous studies of CD in male adolescents.
Although the quality of the parent-teen relationship is key to understanding both psychopathology and well-being in adolescence, there are limited assessments of adolescents' underlying attitudes ...regarding their parents. This study aimed to evaluate a novel and brief method of coding adolescents' 3-min speech samples regarding their affective attitudes (e.g., thoughts and feelings) toward their parent. A community sample of 72 adolescents (M age = 16 years) completed a 3-min speech sample and several questionnaire measures of the quality of the parent-teen relationship and adolescents' psychosocial outcomes. Speech samples were coded for critical and warm affective attitudes toward the parent using the Family Affective Attitude Rating Scale (FAARS). Results showed that FAARS negative relational schemas (NRS) and positive relational schemas (PRS) scales were reliable and converged with questionnaire assessments of attachment and relationship quality, antisocial outcomes, and pro-social behavior. When included in the same model, adolescents' NRS, but not the questionnaire measures, was uniquely associated with externalizing behavior and prosocial behavior. Furthermore, adolescents' PRS, but not the questionnaires, was uniquely associated with callous-unemotional traits. Results suggest that the FAARS coding scheme can reliably assess adolescents' affective attitudes toward their parents and that this information is relevant to understanding adolescents' psychosocial outcomes. The implications of these findings for multimethod clinical assessments, large cohort research, and adolescents' therapeutic outcomes are discussed.
In the present study, we examined the relationship between developmental modulation of socioaffective brain systems and adolescents' preoccupation with social evaluation. Child, adolescent, and adult ...participants viewed cues indicating that a camera was alternately off, warming up, or projecting their image to a peer during the acquisition of behavioral-, autonomic-, and neural-response (functional MRI) data. Believing that a peer was actively watching them was sufficient to induce self-conscious emotion that rose in magnitude from childhood to adolescence and partially subsided into adulthood. Autonomic arousal was uniquely heightened in adolescents. These behavioral patterns were paralleled by emergent engagement of the medial prefrontal cortex (MPFC) and striatum-MPFC connectivity during adolescence, which are thought to promote motivated social behavior in adolescence. These findings demonstrate that adolescents' self-consciousness is related to age-dependent sensitivity of brain systems critical to socioaffective processes. Further, unique interactions between the MPFC and striatum may provide a mechanism by which social-evaluation contexts influence adolescent behavior.
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