O impacto de um protocolo transdiagnóstico de prevenção de ansiedade e depressão em adolescentes

The present study examined the benefit of a transdiagnostic prevention program, Super Skills for Life – adolescent version (SSL-A), among adolescents with internalizing and externalizing problems in two types of school settings (mainstream school and pupil referral unit) using a randomized waitlist-controlled trial (RCT). The main aims were to examine the effects of the SSL-A in reducing internalizing and externalizing problems in adolescents, and to identify the moderating role of gender, age, and school type on the intervention outcome. The RCT involved 112 adolescents aged 11 to 14 years old, randomly allocated to either an SSL-A intervention group or a waitlist-control group (WLC). Adolescents in the intervention group participated immediately in the SSL-A, whereas adolescents in the WLC group received the intervention after the intervention group completed the six months follow-up assessment. Results showed that internalizing and externalizing problems were significantly reduced from pre-test to follow-up assessments. Gender, age and school setting moderated the intervention outcome. Specifically, males, younger adolescents and adolescents from mainstream schools showed a significant reduction over time on both internalizing and externalizing problems. Although SSL was designed to target internalizing problems, this study shows that it also had positive effects on adolescents with internalizing and externalizing problems. This study provides evidence for the benefits of a transdiagnostic prevention program for internalizing and externalizing problems in two types of school settings.O presente estudo explorou a eficácia do programa transdiagnóstico de prevenção, Super Skills for Life – versão adolescente (SSL-A), em adolescentes com problemas internalizantes e externalizantes em dois tipos de escolas (escolas públicas convencionais e pupil referral units) usando um estudo randomizado controlado com lista de espera (RCT). Os objetivos principais consistiram em examinar os efeitos do SSL-A na redução de problemas internalizantes e externalizantes em adolescentes, e identificar o papel moderador do género, idade e tipo de escola nos resultados da intervenção. O RCT envolveu 112 adolescentes, entre os 11 e os 14 anos, distribuídos aleatoriamente para o grupo de intervenção SSL-A ou para o grupo de lista de espera. Os adolescentes do grupo de intervenção participaram imediatamente no programa SSL-A, enquanto os adolescentes do grupo de espera receberam a intervenção após o grupo de intervenção ter completado a avaliação do seguimento de seis meses. Os resultados mostraram que os problemas de internalização e externalização foram significativamente reduzidos do pré-teste para as avaliações de seguimento. O género, a idade e o tipo de escola moderaram os resultados da intervenção. Mais especificamente, rapazes, adolescentes mais novos e adolescentes de escolas convencionais mostraram uma redução significativa de problemas internalizantes e externalizantes ao longo do tempo. Embora o SSL tenha sido desenhado para os problemas de internalização, este estudo mostrou que o programa também teve efeitos positivos nos adolescentes com problemas de internalização e externalização

Adolescent psychopathological profiles and the outcome of the COVID-19 pandemic: Longitudinal findings from the UK Millennium Cohort Study

Background: According to cross-sectional studies, public health measures to contain the spread of COVID-19 are associated with adverse effects, including high level of psychological distress, anxiety, and depression. Aims: This study explored adolescent psychopathological profiles at age 17, and their role in predicting the impact of the COVID-19 pandemic at age 19. Methods: The analyses used a sample of 904 participants (mean age = 19.17 years) from the Millennium Cohort Study (MCS) sweep 7 who completed the mental health questions from January 2018 to March 2019 (mean age = 17.18 years) and the COVID-19 Survey in May 2020. Adolescent psychopathological profiles were identified by means of latent class analysis. Results: Four psychopathological profiles were identified: “low-symptom class” (60.17% of participants), “high-symptom class” (23.01% of participants), “substance/behavioural addictions class” (12.03% of participants), and “emotion-dysregulation class” (4.79% of participants). Adolescents in the high-symptom and emotional-dysregulation classes had the worst outcome during the lockdown. Specifically, they experienced more stress, conflict and loneliness, and lower levels of perceived social support than adolescents in the other psychopathological classes. Adolescents in the emotional-dysregulation class also consumed more alcohol and had worse financial situation during the lockdown compared to pre- lockdown period. Conclusion: Adolescent psychopathological profiles predicted the mental health impacts of the COVID-19 outbreak.Depto. de Medicina Legal, Psiquiatría y PatologíaFac. de MedicinaTRUEpu

Caregiver-reported changes in the socioemotional wellbeing and daily habits of children with special educational needs during the first COVID-19 national lockdown in the UK

The implementation of social distancing measures (e.g., school closures) by governments worldwide to prevent the spread of COVID-19 has affected millions of children and their families. However, the consequences of such measures on the wellbeing of children with special educational needs (SEN) and their caregivers are not fully understood. The present study examined the socioemotional wellbeing and daily habits of children between 5 and 12 years old with SEN during the first national COVID-19 lockdown in the United Kingdom. Participants were 995 caregivers between 18 and 61 years old living in the United Kingdom who completed a 20 -min electronic survey on child and family wellbeing distributed via social networks between July and August 2020. The findings showed that children with SEN were more likely to experience more emotional and behavioral difficulties during the lockdown than children without SEN. Children with SEN but without mental health difficulties did not have more behavior difficulties during the lockdown than children without SEN. There was a significant increase in screen time and decrease in sleep time for children with and without SEN during the lockdown, but children with SEN were using screens more often than children without SEN both before and during the lockdown. Finally, caregivers with children with SEN reported more difficulty with the confinement than caregivers with children without SEN, but caregiver and child poor mental health were likely to explain the difference. The findings show that the wellbeing of children with SEN was more likely to be negatively affected by the lockdown than the wellbeing of children without SEN. Caregiver and child mental health were likely to explain the differences

The Mediating Effects of Self-Esteem on Anxiety and Emotion Regulation.

Individuals with anxiety disorders maladaptively appraise interpersonal threat cues leading to inaccurate interpretations of the self and others. However, little is known about the factors that mediate this association, therefore, the main aim of this study was to examine the relationship between state and trait anxiety, self-esteem, and emotion regulation strategies: reappraisal and suppression. Young adults aged between 18-26 years participated in the study. They completed a set of self-reports measuring emotion regulation, self-esteem, state-trait anxiety, and positive and negative attributes. Participants also completed an experimental task, using the dot-probe paradigm, which measures threat bias and response inhibition. The findings showed that trait and state anxiety predicted suppression, reappraisal, and internalising problems, and is linked to response inhibition. Importantly, low self-esteem, significantly mediated the relationship between increased anxiety and suppression. Taken together, these results show specific associations between emotion regulation and anxiety, highlighting the significant impact of self-esteem in young adults

Effectiveness of the Super Skills for Life programme in enhancing the emotional wellbeing of children and adolescents in residential care institutions in a low- and middle-income country: A randomised waitlist-controlled trial

Background: The present study examined the effectiveness of a transdiagnostic prevention programme, Super Skills for Life (SSL), among children and adolescents with emotional problems in residential care institutions (RCIs) in the low- and middle-income country of Mauritius using a randomised waitlist-controlled trial (RCT). SSL is based on the principles of cognitive behavioural therapy, behavioural activation, social skills training, and uses video-feedback and cognitive preparation as part of the treatment. Methods: The RCT involved 100 children and adolescents aged 9 to 14 years, from six RCIs, randomly allocated to either an SSL intervention group (IG) or a waitlist-control (WLC) group. A set of questionnaires measuring internalising and externalising problems, emotion regulation and self-esteem, and experimental tasks measuring attentional bias and inhibitory control, were completed at baseline, post-intervention and 3-month follow-up. Participants also completed a 2-min video speech task during the first and final sessions of the SSL intervention. Results: Children and adolescents in the IG showed significant improvements in internalising symptoms (e.g. anxiety and depression), externalising symptoms (e.g. conduct problems and hyperactivity), and inhibitory control, and an increase in adaptive (except putting into perspective strategy) and decrease in maladaptive emotion regulation strategies, at both post-intervention and follow-up. These findings were not replicated among children in the WLC. Limitations: The small sample size and lack of an active control group were the major limitations of this study. Conclusions: This study provides evidence for the effectiveness of a transdiagnostic prevention programme for emotional problems in RCIs in a low- and middle-income country

An intersectional analysis of inequalities in young people’s mental health within the higher education context

Taking higher education as a specific social context in which to explore structural and social determinants of inequalities in young people’s mental health, this study used the new gold standard for quantitative intersectionality research (Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy [MAIHDA]) as an analytical approach. Drawing on data from the Longitudinal Study of Young People in England, we used MAIHDA to predict the odds that mental distress during adolescence, sex, socioeconomic status, sexual identity, ethnicity, and their intersections, were associated with young people’s mental health outcomes at age 25. Analyses were performed both within and outside of the higher education context to determine whether university attendance shaped any intersectional effects. The results did not reveal any evidence of intersectional effects (i.e. a multiplicative model) on young people’s mental health outcomes. Significant main effects of social identities (i.e. an additive model) were, however, found: Being female or identifying as a sexual minority increased the odds of young people experiencing mental health problems at age 25, although the odds of self-harming were half the size for sexual minorities who attended university; Black and Asian individuals were less likely to declare a mental illness than White individuals; and young people who grew up in a more deprived area and did not attend university were more likely to experience mental health problems. Implications of the findings are that mental health interventions for young people do not necessarily have to be designed exclusively for specific intersectional groups, but could instead be targeted at broad social group memberships. Since, the university environment appears to produce better mental health outcomes for some young people, further investigation is needed to understand potential benefits afforded by attending university, and to determine whether this should and could be replicated in the wider general population

Mental distress during adolescence and participation in higher education

Background/context. Recent evidence indicates that adolescents experiencing mental distress might be more likely to go on to attend university than those with no symptoms of distress (Lewis et al., 2021). One explanation for this is that future university students might experience greater academic pressures than their peers, which results in heightened mental distress (Lewis et al., 2021; Luthar et al., 2020). However, the mechanisms behind such pressures are unclear. The initiative/practice. In this study, we anticipated that mental distress (consisting of anxiety/depressive symptoms, social dysfunction, and loss of confidence) experienced by future university students might be specifically due to the high-stakes qualifications needed for university admission. Drawing on social comparison theory (Festinger, 1954), we theorised that future university students might make upward social comparisons with peers who they anticipate will perform better than them, and that this causes mental distress. Methods of evaluative data collection and analysis. We conducted logistic regression analyses of longitudinal panel survey data from a population-representative cohort of approximately 8000 young people. Evidence of outcomes and effectiveness. Our analyses confirmed that high-stakes qualifications appeared to be the underlying mechanism causing mental distress. Adolescents with greater mental distress were more likely to attend university in general, as well as attend a more academically selective university. Mental distress symptoms were also greater for those who planned to apply for university, but did not actually attend. By age 25, symptoms were, on the most part, no longer elevated for those who attended, or had planned to attend, university. We argue for a need to target interventions at times when adolescents undertake high-stakes qualifications at school and university

Academic pressures and mental distress during adolescence: associations with participation in higher education

Recent evidence suggests that adolescents with mental health issues are more likely to go on to attend university. Reasons for this point to academic pressures that may cause mental distress potentially being greater for those who plan to attend university. We aimed to investigate this hypothesis further by examining whether the extent to which mental distress is elevated relates to the selectivity of university that young people go on to attend. Logistic regression analyses were performed on survey responses from a nationally representative data set. Young people going on to more selective universities had elevated levels of mental distress at 15 and 17. By age 25, symptoms were no longer elevated for those who had attended either type of university. We argue that additional support needs to be provided during times that adolescents complete qualifications they perceive as being high-stakes