Longitudinal associations between social anxiety symptoms and cannabis use throughout adolescence: the role of peer involvement.

There appear to be contradicting theories and empirical findings on the association between adolescent Social Anxiety Disorder (SAD) symptoms and cannabis use, suggesting potential risk as well as protective pathways. The aim of this six-year longitudinal study was to further examine associations between SAD symptoms and cannabis use over time in adolescents from the general population, specifically focusing on the potential role that adolescents' involvement with their peers may have in these associations. Participants were 497 Dutch adolescents (57 % boys; M age = 13.03 at T1), who completed annual self-report questionnaires for 6 successive years. Cross-lagged panel analysis suggested that adolescent SAD symptoms were associated with less peer involvement 1 year later. Less adolescent peer involvement was in turn associated with lower probabilities of cannabis use as well as lower frequency of cannabis use 1 year later. Most importantly, results suggested significant longitudinal indirect paths from adolescent SAD symptoms to cannabis use via adolescents' peer involvement. Overall, these results provide support for a protective function of SAD symptoms in association with cannabis use in adolescents from the general population. This association is partially explained by less peer involvement (suggesting increased social isolation) for those adolescents with higher levels of SAD symptoms. Future research should aim to gain more insight into the exact nature of the relationship between anxiety and cannabis use in adolescents from the general population, especially regarding potential risk and protective processes that may explain this relationship.

Decreases in adolescent weekly alcohol use in Europe and North America: evidence from 28 countries from 2002 to 2010.

BACKGROUND: This study examined trends in adolescent weekly alcohol use between 2002 and 2010 in 28 European and North American countries. METHODS: Analyses were based on data from 11-, 13- and 15-year-old adolescents who participated in the Health Behaviour in School-Aged Children (HBSC) study in 2002, 2006 and 2010. RESULTS: Weekly alcohol use declined in 20 of 28 countries and in all geographic regions, from 12.1 to 6.1% in Anglo-Saxon countries, 11.4 to 7.8% in Western Europe, 9.3 to 4.1% in Northern Europe and 16.3 to 9.9% in Southern Europe. Even in Eastern Europe, where a stable trend was observed between 2002 and 2006, weekly alcohol use declined between 2006 and 2010 from 12.3 to 10.1%. The decline was evident in all gender and age subgroups. CONCLUSIONS: These consistent trends may be attributable to increased awareness of the harmful effects of alcohol for adolescent development and the implementation of associated prevention efforts, or changes in social norms and conditions. Although the declining trend was remarkably similar across countries, prevalence rates still differed considerably across countries.

Cross-national evidence for the clustering and psychosocial correlates of adolescent risk behaviours in 27 countries.

BACKGROUND: According to Jessor's Problem Behaviour Theory (PBT) and Moffitt's theory of adolescence-limited antisocial behaviour, adolescent risk behaviours cluster and can be predicted by various psychosocial factors including parent, peer and school attachment. This study tested the potential influence of the sociocultural, or macro-level, environment on the clustering and correlates of adolescent risk behaviour across 27 European and North American countries. METHODS: Analyses were based on data from the 2009-10 Health Behaviour in School-aged Children (HBSC) study. Participants compromised 56,090 adolescents (M(age) = 15.5 years) who self-reported on substance use (tobacco, alcohol, cannabis) and early sexual activity as well as on psychosocial factors (parent, peer and school attachment). RESULTS: Multiple group confirmatory factor analyses (with country as grouping variable) showed that substance use and early sexual activity loaded on a single underlying factor across countries. In addition, multiple group path analyses (with country as grouping variable) showed that associations between this factor and parent, peer and school attachment were identical across countries. CONCLUSION: Cross-national consistencies exist in the clustering and psychosocial correlates of substance use and early sexual activity across western countries. While Jessor's PBT stresses the problematic aspects of adolescent risk behaviours, Moffitt emphasizes their normative character. Although the problematic nature of risk behaviours overall receives more attention in the literature, it is important to consider both perspectives to fully understand why they cluster and correlate with psychosocial factors. This is essential for the development and implementation of prevention programmes aimed at reducing adolescent risk behaviours across Europe and North America.

Improving Screening Cut-Off Scores for DSM-5 Adolescent Anxiety Disorder Symptom Dimensions with the Screen for Child Anxiety Related Emotional Disorders.

Presently most adolescent anxiety disorder screening instruments make their determination of running a high risk for an anxiety disorder on the basis of a cut-off score measured by a single screening which can lead to false positives. Therefore, the goal of this study is to examine whether a repeated administration of the SCARED screening instrument for DSM-5 anxiety disorder symptoms could help in the detection of true positives while also avoiding false positives. Participants were 923 early adolescents from the general community. The adolescents' ages at the first annual screening ranged from 10 to 15 with an average of 12.5 years. In a prospective five-year longitudinal design, the adolescents completed the SCARED screening instrument for anxiety disorder symptoms on a yearly basis. To detect true positives and avoid false positives, the data were analyzed with Receiver Operating Characteristics (ROC) cut-off score analyses. ROC cut-off score analyses revealed that the sensitivity and specificity of high risk were greatly improved for repeated screenings above those of a single screening. The findings of this study demonstrate that a screening instrument (such as the SCARED) should be administered not just once but several times in order to better determine true positives and avoid false positives.

Heterogeneity in development of adolescent anxiety disorder symptoms in an 8-year longitudinal community study.

In this study, we prospectively examined developmental trajectories of five anxiety disorder symptom dimensions (generalized anxiety disorder, panic disorder, school anxiety, separation anxiety disorder, and social anxiety disorder) from early to late adolescence in a community sample of 239 adolescents, assessed annually over 8 years. Latent growth modeling indicated different developmental trajectories from early into late adolescence for the different anxiety disorder symptoms, with some symptoms decreasing and other symptoms increasing over time. Sex differences in developmental trajectories were found for some symptoms, but not all. Furthermore, latent class growth analysis identified a normal developmental profile (including a majority of adolescents reporting persistent low anxiety disorder symptoms over 8 years) and an at-risk developmental profile (including a minority of adolescents reporting persistent high anxiety disorder symptoms over 8 years) for all of the anxiety disorder symptom dimensions except panic disorder. Additional analyses longitudinally supported the validity of these normal and at-risk developmental profiles and suggested differential associations between different anxiety disorder symptom dimensions and developmental trajectories of substance use, parenting, and identity development. Taken together, our results emphasize the importance of examining separate dimensions of anxiety disorder symptoms in contrast to a using a global, one-dimensional approach to anxiety.

Psychometric properties of the screen for child anxiety related emotional disorders for socially anxious and healthy Spanish adolescents.

Socially anxious and healthy Spanish adolescents were studied in order to test the psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED). Confirmatory factor analyses were employed to test measurement invariance between these two populations, Cronbach's alphas were calculated to determine the reliabilities of the scales, and partial eta-square tests calculated the effect size of the differences between socially anxious and healthy adolescents and between the adolescent boys and girls. The psychometric properties of the SCARED were good, as demonstrated by having acceptable reliabilities (ranging from .75 - .41) and a moderate multivariate effect size (η(p)(2) = .08) between the adolescent boys and girls. Most importantly, it was demonstrated that the SCARED could differentiate between socially anxious and healthy Spanish adolescents as demonstrated by measurement invariance (χ(2) = 254.27, df = 1343, GFI = .884, AGFI = .872, RMR = .031) and the large effect size (η(p)(2) = .22) between the samples.

Effects of nicotine dependence and depressive symptoms on smoking cessation: a longitudinal study among adolescents.

INTRODUCTION: Nicotine dependence has been shown to hamper successful smoking cessation in adolescents. Nicotine dependence and depression are highly comorbid, but the relation between depression and smoking cessation is not yet fully understood. Therefore, the present study examines both the longitudinal reciprocal relation between nicotine dependence and depressive symptoms, and the longitudinal effect of these factors on successful smoking cessation and number of quit attempts. METHODS: A 2-wave longitudinal study was conducted among 535 adolescents aged 13-18. Written self-report questionnaires were administered in a classroom setting. Two models were tested, examining the mutual relation between nicotine dependence and depressive symptoms, as well as the predictive value of these factors on smoking cessation (n = 535), and number of quit attempts (n = 473) 1 year later. RESULTS: Adolescents with more depressive symptoms have significantly higher levels of nicotine dependence 1 year later. Higher levels of nicotine dependence negatively predicted subsequent successful smoking cessation, whereas depressive symptoms did not. In contrast, depressive symptoms predicted a higher number of unsuccessful quit attempts in the following year, whereas nicotine dependence did not. CONCLUSIONS: The findings suggest that adolescents tend to smoke cigarettes in order to diminish their depressive feelings, which might provide some support for the self-medication theory. Smoking cessation programs aiming at adolescents should not only focus on symptoms of nicotine dependence but should also pay attention to depressive feelings, since these feelings are related to a higher number of unsuccessful quit attempts.

Psychometric properties of the screen for child anxiety related emotional disorders for socially anxious and healthy Spanish adolescents

Socially anxious and healthy Spanish adolescents were studied in order to test the psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED). Confirmatory factor analyses were employed to test measurement invariance between these two populations, Cronbach’s alphas were calculated to determine the reliabilities of the scales, and partial eta-square tests calculated the effect size of the differences between socially anxious and healthy adolescents and between the adolescent boys and girls. The psychometric properties of the SCARED were good, as demonstrated by having acceptable reliabilities (ranging from .75 - .41) and a moderate multivariate effect size (çp2 = .08) between the adolescent boys and girls. Most importantly, it was demonstrated that the SCARED could differentiate between socially anxious and healthy Spanish adolescents as demonstrated by measurement invariance (÷2 = 254.27, df = 1343, GFI = .884, AGFI = .872, RMR = .031) and the large effect size (çp2 = .22) between the samples (AU)

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Explaining educational differences in adolescent substance use and early sexual debut: the role of parents and peers.

Previous studies from a wide variety of European countries have demonstrated that low educated adolescents engage more frequently in health risk behaviors compared to high educated adolescents. The present study investigates the mediating roles of parental knowledge and time spent with peers in this relationship. Data were retrieved from a nationally representative sample of 12- to 16-year old Dutch adolescents (N=5422). Risk behaviors were measured by adolescents' report of daily smoking, binge drinking and cannabis use in the previous month, and sexual debut before age 17. Low educated adolescents indicated that their parents had less knowledge on their whereabouts and reported spending more time with peers than high educated adolescents. Both factors mediated the relationship with health risk behaviors. These results hint to parenting practices and adolescent peer relations as points of reference for prevention and intervention work aiming to reduce educational inequalities in adolescent health risk behaviors.

Replication of the five-dimensional structure of positive psychotic experiences in young adulthood.

Previous work has examined the structure of subclinical positive psychotic experiences. The current study, using confirmatory factor analysis in a general population sample of young adult females, replicated a five-dimensional model, which showed excellent model fit. The results suggest stability of the five-dimensional model across adolescent and young adult life.

The role of adolescents' morality and identity in volunteering. Age and gender differences in a process model.

The aim of this study was to explain adolescents' volunteering in terms of their morality and identity and to examine the moderation effect of gender and age in this process. Data were collected among 698 Dutch adolescents aged 12 to 20 (M = 15.19; SD = 1.43). Adolescents' moral reasoning was positively associated with understanding moral issues and thinking about public responsibility towards these issues. In turn, moral understanding, along with being personally committed to act upon moral issues, were positively associated with identity. Extending the number of identity contexts tended to be related to being more likely to volunteer and to more volunteering involvement. Adolescents' identity integration was not related to how likely they were to volunteer, and was negatively related to their volunteering involvement. Clearer effects were found when differentiating between adolescent gender and age groups. Future research could examine this process over time, along with additional factors that may further explain adolescents' volunteering, and examine their age and gender specific effects.

Prenatal smoking exposure and the risk of behavioral problems and substance use in adolescence: the TRAILS study.

AIMS: To study the prospective relationship between maternal smoking during pregnancy (MSP) and behavioral problems, heavy alcohol use, daily smoking, and ever use of cannabis in the offspring, and to assess the role of confounding and mediating factors in a systematic way. METHODS: Population-based cohort study of 2,230 respondents, starting in 2001 when respondents were around the age of 11 years, and two follow-up measurements at intervals of about 2.5 years (response rates of 96.0 and 81.4%). RESULTS: Almost one third of the respondents' mothers had smoked tobacco during pregnancy. These respondents were at an increased risk for all outcomes except internalizing problems (significant odds ratios ranged from 1.40 to 2.97). The successive models showed that the potential confounding factors reduced the strength of all relationships. In the full model, the strongest relationship was found for mothers who smoked more than 10 cigarettes a day during pregnancy and daily smoking in early adolescence (odds ratio: 1.56), but none of the relationships were statistically significant. CONCLUSIONS: MSP is a marker for future behavioral outcomes in the offspring, but reducing the prevalence of MSP is unlikely to make a meaningful contribution to the prevention of these problems in adolescents.

Come rain or come shine: individual differences in how weather affects mood.

There is a widespread belief that weather affects mood. However, few studies have investigated this link, and even less is known about individual differences in people's responses to the weather. In the current study, we sought to identify weather reactivity types by linking self-reported daily mood across 30 days with objective weather data. We identified four distinct types among 497 adolescents and replicated these types among their mothers. The types were labeled Summer Lovers (better mood with warmer and sunnier weather), Unaffected (weak associations between weather and mood), Summer Haters (worse mood with warmer and sunnier weather), and Rain Haters (particularly bad mood on rainy days). In addition, intergenerational concordance effects were found for two of these types, suggesting that weather reactivity may run in the family. Overall, the large individual differences in how people's moods were affected by weather reconciles the discrepancy between the generally held beliefs that weather has a substantive effect on mood and findings from previous research indicating that effects of weather on mood are limited or absent.

The direction of effects between perceived parental behavioral control and psychological control and adolescents' self-reported GAD and SAD symptoms.

This study examined the direction of effects and age and sex differences between adolescents' perceptions of parental behavioral and psychological control and adolescents' self-reports of generalized anxiety disorder (GAD) and separation anxiety disorder (SAD) symptoms. The study focused on 1,313 Dutch adolescents (early-to-middle cohort n = 923, 70.3%; middle-to-late cohort n = 390, 29.7%) from the general population. A multi-group, structural equation model was employed to analyze the direction of the effects between behavioral control, psychological control and GAD and SAD symptoms for the adolescent cohorts. The current study demonstrated that a unidirectional child effect model of the adolescents' GAD and SAD symptoms predicting parental control best described the data. Additionally, adolescent GAD and SAD symptoms were stronger and more systematically related to psychological control than to behavioral control. With regard to age-sex differences, anxiety symptoms almost systematically predicted parental control over time for the early adolescent boys, whereas no significant differences were found between the late adolescent boys and girls.

How does longitudinally measured maternal expressed emotion affect internalizing and externalizing symptoms of adolescents from the general community?

BACKGROUND: In previous studies, maternal expressed emotion (EE) has been found to be a good predictor of the course of adolescent internalizing and externalizing symptoms. However, these studies have been cross-section as opposed to longitudinal. The goal of this study is to examine longitudinal data of perceived maternal EE and adolescent internalizing and externalizing symptoms to determine if maternal EE affected the course of adolescent symptoms (a parent effect model), or if the course of adolescent symptoms affected maternal EE (a child effect model), or if maternal EE and adolescent symptoms affected one another bidirectionally. METHODS: Dutch adolescents (N = 497; 57% boys; M = 13 years) from the general community and their mothers were prospectively studied annually for three years. At all waves the mothers completed the Level of Expressed Emotion (LEE) questionnaire and the adolescents completed self-rated measures of internalizing and externalizing symptoms. Structural equation modeling (SEM) was used to analyze the longitudinal data. RESULTS: The results of the SEM analyses clearly demonstrate that a child effect model best describes the relationship between maternal EE and the course of adolescent internalizing and externalizing symptoms. CONCLUSIONS: This longitudinal study of the mothers' EE perceptions suggests that it is the course of the internalizing and externalizing symptoms of adolescents from the general community that affects maternal EE, and not the mothers' perceived EE influencing the course of the adolescents' symptoms. Since this study was based on adolescents from the general community, it is suggested that these findings should also be replicated in clinical samples of adolescents.

Cross-ethnic generalizability of the three-factor model of psychopathy: the Youth Psychopathic Traits Inventory in an incarcerated sample of native Dutch and Moroccan immigrant boys.

BACKGROUND: Previous research provides support for the existence of the psychopathy construct in youths. However, studies regarding the psychometric properties of psychopathy measures with ethnic minority youths are lacking. METHODS: In the present study, the three-factor structure of the Youth Psychopathic Traits Inventory (YPI) was examined for both native Dutch youth (N=158) and an ethnic minority group, Moroccans (N=141), in an incarcerated adolescent population in the Netherlands. RESULTS: Our results showed that the three-factor structure of the YPI is comparable across an ethnic majority and an ethnic minority group in an incarcerated sample in the Netherlands. Moreover, associations between psychopathic traits and mental health problems were similar for both ethnic groups. CONCLUSION: The results support the cross-ethnic generalizability of the three-factor model of psychopathy as measured through the Youth Psychopathic Traits Inventory.

The predictive capacity of perceived expressed emotion as a dynamic entity of adolescents from the general community.

BACKGROUND: In previous studies, it has been demonstrated that high parental expressed emotion (EE) is predictive of depressive, aggressive and delinquency symptoms of adolescents. Two issues have received much less prominence in EE research, these being studies of adolescent perceived EE and the measurement of the EE as a dynamic, developmental construct. This 4-year, three-wave, longitudinal study of perceived EE of adolescents from the general community examines if adolescent perceived EE measured with the traditional, one-measurement EE approach as well as adolescent perceived EE measured with a repeated measured, dynamic EE approach can predict adolescent depressive, aggressive and delinquency symptoms. METHODS: Dutch adolescents (N = 285; 51% girls; M = 13 years) from the general community were prospectively studied annually for 4 years. At all waves, the adolescents completed the Level of Expressed Emotion (LEE) questionnaire and at the final wave also completed self-rated measures of depressive, aggressive and delinquent symptoms. Growth models were used to predict adolescent symptoms from adolescent perceived EE. RESULTS: Growth models significantly predicted adolescent depressive, aggressive and delinquency symptoms from adolescent perceived EE. CONCLUSIONS: This study of the LEE demonstrates that developmental characteristics of EE are predictive of adolescents' symptoms. These findings hold implications for current EE intervention therapies and the conceptualization of EE.

The structure of the extended psychosis phenotype in early adolescence--a cross-sample replication.

The extended psychosis phenotype, or the expression of nonclinical positive psychotic experiences, is already prevalent in adolescence and has a dose-response risk relationship with later psychotic disorder. In 2 large adolescent general population samples (n = 5422 and n = 2230), prevalence and structure of the extended psychosis phenotype was investigated. Positive psychotic experiences, broadly defined, were reported by the majority of adolescents. Exploratory analysis with Structural Equation Modelling (Exploratory Factor Analysis followed by Confirmatory Factor Analysis [CFA]) in sample 1 suggested that psychotic experiences were best represented by 5 underlying dimensions; CFA in sample 2 provided a replication of this model. Dimensions were labeled Hallucinations, Delusions, Paranoia, Grandiosity, and Paranormal beliefs. Prevalences differed strongly, Hallucinations having the lowest and Paranoia having the highest rates. Girls reported more experiences on all dimensions, except Grandiosity, and from age 12 to 16 years rates increased. Hallucinations, Delusions, and Paranoia, but not Grandiosity and Paranormal beliefs, were associated with distress and general measures of psychopathology. Thus, only some of the dimensions of the extended psychosis phenotype in young people may represent a continuum with more severe psychopathology and predict later psychiatric disorder.

A meta-analysis of the cross-cultural psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED).

BACKGROUND: Accumulating studies have demonstrated that the Screen for Child Anxiety Related Emotional Disorders (SCARED), a modern youth anxiety questionnaire with scales explicitly designed to map onto specific DSM-IV-TR anxiety disorders, has good psychometric properties for children and adolescents from various countries. However, no study has yet been conducted as to the overall strength of the psychometric properties found in these studies. METHODS: Studies were collected from the PsycINFO, PubMed, SSCI, SCI-Expanded, ERIC, and A&HCI databases from the year of the SCARED's first publication (1997) to the present. The inclusion criteria focused on all studies that examined the psychometric properties of the SCARED. RESULTS: We retained 21 articles, reporting a total of 25 studies from predominantly Europe (Belgium, Germany, Italy, the Netherlands) and the USA, as well as South Africa and China, which matched our inclusion criteria. It was found that the psychometric properties were robust for the SCARED scales related to the symptoms of DSM-IV-TR anxiety disorders, that females scored significantly higher than males and that age had a moderating effect on male and female score differences. CONCLUSIONS: This meta-analysis suggests that the SCARED can be utilized as a screening instrument for DSM-IV-TR anxiety disorder symptom dimensions for children and adolescents from various countries.

Identity formation in adolescence: change or stability?

The aim of this five-wave longitudinal study of 923 early to middle adolescents (50.7% boys; 49.3% girls) and 390 middle to late adolescents (43.3% boys and 56.7% girls) is to provide a comprehensive view on change and stability in identity formation from ages 12 to 20. Several types of change and stability (i.e., mean-level change, rank-order stability, and profile similarity) were assessed for three dimensions of identity formation (i.e., commitment, in-depth exploration, and reconsideration), using adolescent self-report questionnaires. Results revealed changes in identity dimensions towards maturity, indicated by a decreasing tendency for reconsideration, increasingly more in-depth exploration, and increasingly more stable identity dimension profiles. Mean levels of commitment remained stable, and rank-order stability of commitment, in-depth exploration, and reconsideration did not change with age. Overall, girls were more mature with regard to identity formation in early adolescence, but boys had caught up with them by late adolescence. Taken together, our findings indicate that adolescent identity formation is guided by progressive changes in the way adolescents deal with commitments, rather than by changes in the commitments themselves.