Effects of Brief Interventions on Internalizing Symptoms and Substance Use in Youth: A Systematic Review

Internalizing problems (e.g., depression, anxiety) and substance use are common among young people and often co-occur. However, youths face myriad barriers to access needed treatment, and existing evidence-based interventions tend to focus on internalizing problems or substance use, rather than both simultaneously. Brief interventions that target both problems may therefore be an efficient and accessible resource for alleviating youth difficulties; however, this possibility has been insufficiently evaluated. This systematic review evaluated the intervention characteristics and quality of six studies spanning 2015 to 2019 that examined intervention effects on internalizing and substance use outcomes. Based on independent calculations and author reports (respectively), 3-4 interventions significantly reduced youth internalizing symptoms; 3-5 reduced youth substance use; and 2-3 reduced symptoms in both domains. All six interventions identified substance use as a primary target. Four interventions were administered by interventionists to youths in inpatient, outpatient, primary care, or school settings. The remaining two studies delivered content through voicemail messages or an online design. Interventions ranged from ~15 minutes to 240 minutes. Results highlight the sparsity and heterogeneity of youth-focused brief interventions that have evaluated program effects on both internalizing problems and substance use outcomes, suggesting a clear need for integrated supports that are also designed for accessibility. Future investigations of brief youth-focused interventions should assess program effects on both internalizing and substance use outcomes; examine mechanisms driving the varied efficacy of identified interventions; and create, refine, and test interventions with potential to address co-occurring internalizing problems and substance use in young people

Informing the Classification of Positive Emotional Experiences: A Multisample Examination of Hierarchical Models of Positive Emotionality

Despite being multifaceted in nature, positive emotional (PE) experiences often are studied using only global PE ratings, and measures assessing more specific PE facets do not converge in their assessment approaches. To address these issues, we examined hierarchical factor structures of ratings of positive emotionality, which reflect propensities toward experiencing PE, in both online community adult (N = 375) and undergraduate (N = 447) samples. Preregistered analyses indicated (a) a broad distinction between tendencies to experience social affection and other PE types, and that (b) PE ratings can be differentiated by as many as four replicable factors of Joviality, Social Affection, Serenity, and Attentiveness. These PE dimensions were associated with distinct personality and psychopathology profiles. Examples of these distinctive associations included Joviality displaying robust positive associations with grandiosity and exhibitionism; conversely, although Social Affection and Joviality were strongly correlated, Social Affection showed associations in the opposite direction with grandiosity and exhibitionism. Other notable results include Serenity (e.g., feeling relaxed) showing negative associations with negative emotionality at a magnitude indicating that Serenity may reflect low levels of negative emotionality to a considerable degree. Collectively, these results highlight the need to consider distinct PE facets in addition to global PE ratings when assessing PE, as important nuance may be lost otherwise. Furthermore, our results indicate the need for additional research clarifying PE structure at different levels of abstraction to inform future measure development efforts and assessment approaches

Associations of LGBTQ+ Identities with Acceptability and Efficacy of Online Single-Session Youth Mental Health Interventions

Background: Barriers such as stigma, financial costs, and provider shortages prevent large portions of youth with depression and related difficulties from accessing treatment; LGBTQ+ youth are burdened with additional barriers related to minority stress. Single session interventions (SSIs) have been found to benefit youth and help reduce depression symptoms, and since many SSIs are brief, cost-free, and accessible online, they may circumvent several access barriers. However, prior to recommending non-community-tailored SSIs as a useful resource for minoritized youths, we first assessed whether LGBTQ+ youth respond as positively to SSIs as do cisgender heterosexual youth. Methods: In a subsample of youths recruited via online advertisements from 9/2019-8/2020 (N=258, 81.4% female assigned sex, 60.5% LGBTQ+, 47.3% people of color), we investigated whether changes in helplessness, agency, and self-hate from before to after completing online self-directed SSIs differed as a function of LGBTQ+ identity. We also quantitatively and qualitatively compared intervention acceptability ratings and feedback across LGBTQ+ and cisgender heterosexual youths. Results: Analyses revealed no significant differences between cisgender LGBQ+, trans and gender diverse, and cisgender heterosexual youths for any intervention outcomes. Likewise, no group differences emerged in intervention acceptability ratings or written program feedback. Limitations: Self-selection bias and underrepresentation of certain populations, such as American Indian and Alaskan Native youths, may limit generalizability of results. Conclusions: Results suggest that online mental health SSIs are equally acceptable and useful to LGBTQ+ and non-LGBTQ+ youth alike, even prior to culturally specific tailoring

Loneliness in Gender- and Sexual Orientation-Diverse Adolescents: Measurement Invariance Analyses and Between-Group Comparisons

Youth loneliness is a risk factor for myriad adverse psychosocial outcomes, making it a potentially informative construct for assessment and treatment research. Minority stressors may place LGBTQ+ youths at high risk for loneliness. However, the prevalence of loneliness across gender and sexual identities cannot be precisely estimated or compared without establishing that common measures assess the construct equivalently across groups. In a preregistered study, we determined the optimal structure of the UCLA Loneliness Scale and investigated whether it showed invariance across gender and sexual identities in a national U.S. sample of adolescents with elevated depressive symptoms (N=2,431; https://osf.io/52ctd). Results supported strict invariance, indicating that loneliness scores can be meaningfully compared across groups in this sample. Exploratory analyses indicated that loneliness levels and LGBTQ+ identity predicted levels of depression and anxiety. We discuss implications for research on loneliness, health disparities, and psychopathology in high-symptom youths