The Grow It! app-longitudinal changes in adolescent well-being during the COVID-19 pandemic: a proof-of-concept study.

Adolescent mental health and well-being have been adversely impacted by the COVID-19 pandemic. In this preregistered longitudinal study, we evaluated whether adolescents' well-being improved after playing the multiplayer serious game app Grow It! During the first lockdown (May-June 2020), 1282 Dutch adolescents played the Grow It! app (age = 16.67, SD = 3.07, 68% girls). During the second lockdown (December-May 2020 onwards), an independent cohort of 1871 adolescents participated (age = 18.66, SD = 3.70, 81% girls). Adolescents answered online questionnaires regarding affective and cognitive well-being, depressive symptoms, anxiety, and impact of COVID-19 at baseline. Three to six weeks later, the baseline questionnaire was repeated and user experience questions were asked (N = 462 and N = 733 for the first and second cohort). In both cohorts, affective and cognitive well-being increased after playing the Grow It! app (t = - 6.806, p < 0.001; t = - 6.77, p < 0.001; t = - 6.12, p < 0.001; t = - 5.93, p < 0.001; Cohen's d range 0.20-0.32). At the individual level, 41-53% of the adolescents increased in their affective or cognitive well-being. Adolescents with higher risk profiles (i.e., more depressive symptoms, lower atmosphere at home, and more COVID-19 impact) improved more strongly in their well-being. Positive user evaluations and app engagement were unrelated to changes in affective and cognitive well-being. This proof-of-concept study tentatively suggests that Grow It! supported adolescents during the pandemic.

The Longitudinal Association between Self-esteem and Depressive Symptoms in Adolescents: Separating between-person effects from within-person effects.

Many longitudinal studies have investigated whether self-esteem predicts depressive symptoms (vulnerability model) or the other way around (scar model) in adolescents. The most common method of analysis has been the Cross-lagged Panel Model (CLPM). The CLPM does not separate between-person effects from within-person effects, making it unclear whether the results from previous studies actually reflect the within-person effects, or whether they reflect differences between people. We investigated the associations between self-esteem and depressive symptoms at the within-person level, using Random Intercept Cross-Lagged Panel Models (RI-CLPM). To get an impression of the magnitude of possible differences between the RI-CLPM and CLPM, we compared the results of both models. We used data from three longitudinal adolescent samples (age range 7-18; Study 1: N=1,948; Study 2: N=1,455; Study 3: N=316). Intervals between the measurements were 1-1.5 years. Single-paper meta-analyses showed support for small within-person associations from self-esteem to depressive symptoms, but not the other way around, thus only providing some support for the vulnerability model. The cross-lagged associations in the aggregated RI-CLPM and CLPM showed similar effect sizes. Overall, our results show that over 1-1.5 year time intervals, low self-esteem may negatively influence depressive symptoms over time within adolescents, but only weakly so.

Baseline dimensional psychopathology and future mood disorder onset: findings from the Dutch Bipolar Offspring Study.

OBJECTIVE: To identify the early signs of mood disorder development, specifically bipolar disorder (BD), in a population at familial risk for BD. METHOD: The sample included 107 Dutch adolescent bipolar offspring (age 12-21) followed into adulthood (age 22-32). Lifetime DSM-IV axis I diagnoses were examined at baseline, 1-, 5-, and 12- year follow-up. Symptoms were assessed at baseline on a 3-point Likert scale at baseline with the K-SADS-PL and were analyzed using symptom and sum scores. As observed in previous studies, BD typically starts with other mood disorders. Therefore, the sample was stratified in offspring with a mood diagnosis (n = 29) and without (n = 78) at baseline. RESULTS: Subthreshold manic experiences proved the strongest predictor of BD conversion (n = 10; HR2.16, CI95% 1.23-3.78). At symptom level, elated mood, decreased need of sleep, racing thoughts, suicidal ideation, and middle insomnia were significantly associated with BD conversion. Depressive symptoms proved the strongest predictor for first mood episode onset (n = 28; HR1.27, CI95% 1.02-1.58). CONCLUSION: This study extends our knowledge of prodromal manifestations of BD in a high-risk population. Although preliminary, findings of this study provide potential targets for early identification and underscore the importance of detailed assessment of manic symptomatology in bipolar offspring.

Childhood Predictors and Adult Life Success of Adolescent Delinquency Abstainers.

While much is known about adolescent delinquency, considerably less attention has been given to adolescent delinquency abstention. Understanding how or why some adolescents manage to abstain from delinquency during adolescence is informative for understanding and preventing adolescent (minor) delinquency. Using data from the Cambridge Study in Delinquent Development (N = 411 males) to compare abstainers, self-report delinquents and convicted delinquents we found five childhood factors (ages 8-10) that predicted adolescent abstention (ages 10-18). First, we find that adolescent abstainers possess characteristics opposite to those of convicted delinquents (namely, abstainers are high on honesty, conformity and family income). However, we also found that abstainers also share some childhood characteristics with convicted delinquents (namely, low popularity and low school achievement). A latent class analysis indicated that the mixed factors predicting abstention can be accounted for by two groups of abstainers: an adaptive group characterized by high honesty, and a maladaptive group characterized by low popularity and low school achievement. Further, validation of these two types of abstainers using data collected at age 48 suggested that adaptive abstainers outperform all other adolescents in general life success, whereas maladaptive abstainers only fare better than delinquent adolescents in terms of lower substance use and delinquency later in life.

A longitudinal biosocial study of cortisol and peer influence on the development of adolescent antisocial behavior.

It is increasingly recognized that in order to understand the complex phenomenon of antisocial behavior, interrelations between biological and social risk factors should be taken into account. In the current study, this biosocial approach was applied to examine the mediating role of deviant peers in longitudinal associations linking the level of hypothalamic-pituitary-adrenal (HPA) axis activity to aggression and rule-breaking. Participants were 425 boys and girls from the general population, who were assessed yearly at ages 15, 16, and 17. As a measure of HPA axis activity, cortisol was assessed at awakening, 30, and 60 min later (the cortisol awakening response, CAR). Participants, as well as their best friend, reported on their own aggressive and rule-breaking behavior, thereby allowing to assess bidirectional influences within friendships. Aggression was only predicted by a decreased cortisol level at awakening, and not by aggressive behavior of their friend. Decreased levels of cortisol at awakening predicted adolescents' rule-breaking, which subsequently predicted increased rule-breaking of their best friend. The latter was only found for adolescents who changed friends, as compared to adolescents with the same friend in every year. Gender differences were not found. These findings suggest that interrelations between biological and social risk factors are different for the development of aggression versus rule-breaking. Furthermore, decreased levels of HPA axis activity may represent a susceptibility to selecting deviant peers.