Patient-reported burden associated with pheochromocytoma/paraganglioma diagnosis.

Pheochromocytoma and paragangliomas (PPGLs) originate from the chromaffin cells of the adrenal medulla or neural crest progenitors outside the adrenal gland, respectively. The estimated annual incidence of PPGL is between 2.0 and 8.0/million adults. Minimal data exist on the impact of PPGL from the patient's perspective. Therefore, a survey was adapted from a previously published study on gastroenteropancreatic neuroendocrine tumors to explore the voice of patients with PPGL and learn ways to improve clinical care while understanding the current gaps to direct future research. A self-reported online survey was available to patients with PPGL and those with genetic predisposition even without PPGL from June to July 2022. Survey questions captured sociodemographic and clinical characteristics, the diagnostic workup, treatment and monitoring, quality and access to care, and financial impact. Here, we report the most relevant findings on patient experience of disease burden following diagnosis. A total of 270 people responded, the majority of whom were from the USA (79%), Caucasian (88%), and female (81%). The results of this survey highlight the burden of disease on a patient's daily life, resulting in moderate to severe financial distress, increased travel time to specialized facilities resulting in loss of work and wages, and significant delays in care. Respondents reported being unheard and unacknowledged. With a median time to diagnosis just over 2 years, the physical, mental, and emotional toll are substantial. Increasing access to PPGL specialists and centers could lead to faster diagnoses and better management, which may reduce the burden on both patients and healthcare centers.

Peer Influence during Adolescence: The Moderating Role of Parental Support.

Although many studies show that peers influence the development of adolescent internalizing and externalizing difficulties, few have considered both internalizing and externalizing difficulties in the same study, and fewer have considered the contributions of parents. Using a longitudinal sample of 385 adolescents, the contributions of best friends' internalizing and externalizing difficulties (as assessed in Grade 6; G6: Mage = 13.64 years; 53% female; 40% ethnic or racial minority) were examined as they predicted subsequent adolescent internalizing and externalizing difficulties (at G8); in addition, the moderating role of both maternal and paternal support (at G6) was explored. Structural equation modelling revealed that best friend internalizing difficulties predicted decreases, but that best friend externalizing difficulties predicted increases in adolescents' externalizing difficulties over time. Significant interactions involving both maternal and paternal support revealed that the negative impact of a G6 best friend having internalizing problems on later G8 adolescent externalizing problems was stronger at low levels of maternal and paternal support. The findings highlight the complex, and interactive, influences of friends and parents on the development of internalizing and externalizing symptomatology during adolescence, and underscore the importance of targeting both sources of social influence in research and clinical work.

Young children's preference for solitary play: Implications for socio-emotional and school adjustment.

The purpose of this study was to provide additional psychometric support for the Preference for Solitary Play Interview (PSPI) and to examine the associations between self-reported preference for solitary play and indices of adjustment in early childhood. Participants were N = 340 children attending kindergarten and grade 1. Children completed the PSPI, and teachers provided assessments of children's socio-emotional and school adjustment. In support of the validity of the PSPI, preference for solitary play was positively associated with asocial behaviours. Further, preference for solitary play displayed an indirect (but not direct) association with peer exclusion via asocial behaviours. Findings are discussed in terms of the social and behavioural implications of preference for solitary play in early childhood. Statement of contribution What is already known on this subject? Children who spend more time alone are at increased risk of adjustment difficulties. However, some individuals desire to spend time alone because of an appreciation for solitude. A preference for solitude is not associated with negative adjustment in adults and older youth. What does this study add? This study is among the first to examine self-reported preference for solitary in early childhood. Preference for solitude may not be related to emotional or school difficulties in young children. However, a heightened display of solitary behaviours may still evoke negative responses from peers.

Doing for others: Youth's contributing behaviors and psychological engagement in youth-adult partnerships.

Youth contributions to others (e.g., volunteering) have been connected to indicators of successful development, including self-esteem, optimism, social support, and identity development. Youth-adult partnerships, which involve youth and adults working together towards a shared goal in activity settings, such as youth-serving agencies or recreation organizations, provide a unique opportunity for examining youth contributions. We examined associations between measures of youth's participation in youth-adult partnerships (psychological engagement and degree of partnering) in activity settings and youth contributing behaviors, in two Canadian samples: (a) community-involved youth (N = 153, mean age = 17.1 years, 65% female) and (b) undergraduates (N = 128, mean age = 20.1 years, 92.2% female). We found that degree of partnering and psychological engagement were related to each other yet independently predicted contributing behaviors. Our findings suggest that youth-adult partnerships might be one potentially rich context for the promotion of youth's contributions to others.

Youth-Adult Partnerships and Youth Identity Style.

Youth-adult partnerships (e.g., youth leading programs, participating as members of advisory boards) are a common and widely recommended practice in youth work and youth-serving program settings. Although researchers have suggested that these opportunities contribute to youth's identity development, empirical evidence is lacking. In the current study, we tested associations between identity style and degree of youth voice, collaborative youth-adult relationships, and youth's program engagement in 194 youth participating in youth-adult partnerships (M age = 17.6, 62 % female). We found that these characteristics of youth-adult partnerships predicted higher informational identity style, although only program engagement emerged as a unique predictor. Furthermore, exploratory analysis indicated that these associations were moderated by the type of organization. The findings suggest the need for more research on the multiple dimensions of youth-adult partnerships and their association with youth functioning, as well as pointing to the importance of the broader organizational context of youth-adult partnerships.

Developmental Trajectories of Peer-Reported Aggressive Behavior: The Role of Friendship Understanding, Friendship Quality, and Friends' Aggressive Behavior.

OBJECTIVE: To investigate developmental trajectories in peer-reported aggressive behavior across the transition from elementary-to-middle school, and whether aggressive behavior trajectories were associated with friendship quality, friends' aggressive behavior, and the ways in which children think about their friendships. METHOD: Participants included a community sample of 230 5th grade children who were assessed when they made a transition from elementary-to-middle school (6th grade). Peer nominations were used to assess the target child's and friend's aggressive behavior. Self- and friend reports were used to measure friendship quality; friendship understanding was assessed via a structured interview. RESULTS: General Growth Mixture Modeling (GGMM) revealed three distinct trajectories of peer-reported aggressive behavior across the school transition: low-stable, decreasing, and increasing. Adolescents' understanding of friendship formation differentiated the decreasing from the low-stable aggressive behavior trajectories, and the understanding of friendship trust differentiated the increasing from the low-stable aggressive and decreasing aggressive behavior trajectories. CONCLUSIONS: The findings indicated that a sophisticated understanding of friendship may serve as a protective factor for initially aggressive adolescents as they transition into middle school. Promoting a deepened understanding of friendship relations and their role in one's own and others' well-being may serve as an important prevention and intervention strategy to reduce aggressive behavior.

Measuring psychological engagement in youth activity involvement.

Although psychological engagement (e.g., enjoyment, concentration) may be critical in fostering positive outcomes of youth activity participation, too few studies have been conducted to establish its role in development. Furthermore, an established measurement tool is lacking. In the current study, we evaluated a brief engagement measure with two Canadian samples of youth (Sample 1, N = 290, mean age = 16.9 years, 62% female; Sample 2, N = 1827, mean age = 13.1 years, 54% female). We conducted a confirmatory factor analysis with structural equation modeling to examine the hypothesized structure of the model. We also assessed the measure's validity by testing relations between engagement and both perceived outcomes and positive features of activity settings. Psychological engagement was best captured by three latent cognitive, affective, and relational/spiritual factors and a second-order latent factor. Also, as anticipated, psychological engagement was associated with features of the activity setting and perceived impact.

Preference-for-solitude and adjustment difficulties in early and late adolescence.

Social withdrawal has been associated with adjustment difficulties across development. Although much is known about shyness, little is known about preference-for-solitude; even less is known about its relations with adjustment across different periods of adolescence. We examined whether preference-for-solitude might be differentially associated with adjustment difficulties in early and late adolescence. Self- and parent-reports of withdrawal motivations and adjustment were collected from 234 eighth graders (113 boys; M age = 13.43) and 204 twelfth graders (91 boys; M age = 17.25). Results from structural equation modeling demonstrated that above and beyond the effects of shyness, preference-for-solitude was more strongly associated with adjustment difficulties in 8th grade than in 12th grade. Preference-for-solitude was associated with greater anxiety/depression, emotion dysregulation, and lower self-esteem in 8th grade; these relations were not found in 12th grade. Although preference-for-solitude was associated with lower social competence in both 8th and 12th grades, this relation was significantly stronger in 8th grade than in 12th grade. Findings suggest preference-for-solitude has closer ties to maladjustment in early adolescence than in late adolescence. Interventions targeting preferred-solitary youth in early adolescence may be particularly fruitful.

Alone is a crowd: social motivations, social withdrawal, and socioemotional functioning in later childhood.

The primary goals of this study were to test a conceptual model linking social approach and avoidance motivations, socially withdrawn behaviors, and peer difficulties in later childhood and to compare the socioemotional functioning of different subtypes of withdrawn children (shy, unsociable, avoidant). Participants were 367 children, aged 9-12 years. Measures included assessments of social motivations (i.e., self-reported shyness and preference for solitude) and social withdrawal (observations of solitary behaviors in the schoolyard and self-reports of solitary activities outside of school), as well as self- and parent-reported peer difficulties and internalizing problems. Among the results, both shyness and preference for solitude were associated with socially withdrawn behaviors, which in turn predicted peer difficulties. However, only shyness (but not preference for solitude) also displayed a direct path to peer difficulties. As well, results from person-oriented analyses indicated that different subtypes of socially withdrawn children displayed decidedly different profiles with regard to indices of internalizing problems. For example, whereas unsociable children did not differ from their nonwithdrawn peers on indices of internalizing problems, socially avoidant (i.e., high in both shyness and unsociability) children reported the most pervasive socioemotional difficulties. Findings are discussed in terms of the implications of different forms of social withdrawal for socioemotional functioning in later childhood.

Predictors of adolescent successful development after an exchange: the importance of activity qualities and youth input.

The purpose of this study is to examine the factors involved in predicting successful development after an intensive exchange experience in adolescence. Specifically, we considered the eight positive features, as conceptualized by Eccles and Gootman (2002), as well as the amount of input youth had into their exchange experience as predictors of successful development after the exchange. In this short-term longitudinal study, 242 young, middle, and older adolescents, who participated in a national short-term exchanges program, completed surveys before and after completion of the program. Overall, we found that both the eight positive features and personal input were significantly related to overall successful development after an exchange, controlling for initial reports of successful development. This research contributes to an understanding of the importance of different qualities of activity experiences in overall youth development.

Parent and peer links to trajectories of anxious withdrawal from grades 5 to 8.

Individual differences in trajectories of anxious withdrawal were examined from Grades 5 to 8 across the transition to middle school in a community sample (N = 283), using General Growth Mixture Modeling. Three distinct pathways of anxious withdrawal were identified: low-stable (78%), high-decreasing (12%), and high-increasing (10%). In Grade 6, relative to the low-stable class, greater peer exclusion and more free time spent with mother predicted membership in the high-decreasing class; higher peer exclusion predicted membership in the high-increasing class. Within the high-increasing class, the growth of anxious withdrawal was predicted by lower parental autonomy-granting, less free time with mother, both nurturing and restrictive parenting, and greater peer exclusion. Results highlight the role of both parent-child relationship and peer difficulties in increasing the adjustment risk among youth who are anxiously withdrawn prior to the middle-school transition.

Adolescent peer interaction and trait surgency weaken medial prefrontal cortex responses to failure.

Adolescent risk taking has been known to increase in the presence of peers. We hypothesized that peer interaction reduces the activation of the medial prefrontal cortex (mPFC) that is required for self-regulation of reward-driven behavior. We also expected that mPFC activity would be reduced more in those with greater surgency, a composite trait of behavioral approach, sensation seeking and positive affect. In our study, 20 15-year-old boys played a simulated driving video game alone and in the presence of peers who were encouraged to call out advice while we recorded the feedback-related negativity (FRN) event-related potential in response to an impending car crash. FRN amplitude was reduced both as a function of peer presence and increased surgency. More importantly, we also calculated intracerebral current source density at the time of the FRNs, and found that both greater surgency and peer presence are associated with reduced activity specifically in the mPFC. Riskier performance resulting in more car crashes resulted from the presence of peers only as an interaction with surgency, this interaction being related strongly to reduced activity in the ventromedial PFC.

Brief report: how anxiously withdrawn preadolescents think about friendship.

Previous research suggests that anxiously withdrawn preadolescents demonstrate success in forming friendships, yet these friendships tend to be of lesser quality. Drawing on Selman's (1980) theory of interpersonal understanding, we compared levels of friendship understanding between anxiously withdrawn preadolescents and a sample of non-withdrawn age mates. Fifth graders (N = 116; 58% girls; mean age = 10.33 yrs) completed same-sex friendship and social behavior nominations, as well as a semi-structured clinical interview assessing understanding of various friendship issues in response to a hypothetical friendship dilemma. Results suggest that anxiously withdrawn preadolescents demonstrated lower levels of friendship understanding for some, but not all, friendship issues that may be related to friendship quality. The findings suggest that social cognitive assessments of friendship may be useful in understanding the friendship successes and difficulties of anxiously withdrawn preadolescents.

Brief report: engagement in sport and identity status.

Drawing on identity development theory, the connection between engagement in sport and identity status was examined. First-year undergraduates (n = 116 sport-involved youth; 67% women; mean age = 18.58 yrs) completed measures of interpersonal and ideological identity status (achievement, moratorium, diffusion, foreclosure), along with behavioral (breadth, intensity) and psychological (e.g., enjoyment, competence) indicators of sport engagement. Using structural equation modeling, we examined the relation between latent sport engagement and identity status in interpersonal and ideological domains. As hypothesized, latent sport engagement predicted greater interpersonal (but not ideological) identity achievement. Consistent with identity development theory, an additional specific relation was observed between lower breadth of sport involvement and higher interpersonal identity achievement. Results demonstrate the value of examining behavioral and psychological indicators of sport engagement jointly, and support a growing body of research linking sport and positive youth development.

Behavioral Changes Predicting Temporal Changes in Perceived Popular Status.

The primary objectives of this investigation were to determine the extent to which young adolescents are stable in high perceived popular status across the middle school transition and to examine whether changes in social behaviors predict the stability, gain, and loss of perceived popular status after the transition. The sample included 672 young adolescents (323 boys) who completed peer-nomination assessments of social behavior and perceived popularity at the end of elementary school (5(th) grade) and the beginning of middle school (6(th) grade). Findings indicated that 62 percent of perceived popular adolescents remained stable in their high popular status across the middle school transition. Multinomial logistic regression analyses revealed that a combination of aggression and arrogance/conceit was associated with stable and newly-gained perceived popular status after the middle school transition. Taken together, findings highlight the significance of contextual and temporal changes in adolescents' perceived popular status.

Youth engagement and suicide risk: testing a mediated model in a Canadian community sample.

Suicide is a leading cause of death among adolescents in many industrialized countries. We report evidence from a mediation model linking greater youth activity engagement, spanning behavioral and psychological components, with lower suicide risk through five hypothesized intrapersonal and interpersonal mediating factors. Self-report survey data (15% French, 85% English) were gathered from a community sample of 5,015 Canadian adolescents participating in a mental health promotion program. Youth (M(age) = 15.77, SD = 1.42, 50% female) were from two urban centers in southern Ontario, Canada. Youth engagement (youth's most important type of activity, frequency of involvement, and psychological engagement), suicide risk predictive factors (self-esteem, current concerns, depressive symptoms, coping ability, and connections with others), and suicide risk (ideation and attempts) were assessed. Consistent with the hypothesized mediation model, enjoyment and stress in youth's most important activity and various activity types were associated with the various hypothesized suicide risk predictive factors, which in turn were related to suicide risk. Implications for conceptualizations of youth engagement as a multidimensional construct and for suicide risk prevention efforts are discussed.

Attachment, Social Information Processing, and Friendship Quality of Early Adolescent Girls and Boys.

Sixth-graders (N = 223; 109 girls) completed questionnaires assessing their attachment security with their mothers and fathers, their social information processing (SIP) when faced with ambiguously caused hypothetical negative events involving a close friend, and the quality of the relationship with that friend. Aspects of more maladaptive SIP were significantly related to lower levels of security. The overall pattern of results did not provide strong evidence for mediation, although boys' anger did tend to mediate the relation between attachment to mother and friendship quality. Results are consistent with attachment theory and suggest that the mechanisms connecting attachment and friendship are specific with regard to the relationships boys and girls have with their fathers and mothers.

Distinguishing Children Who Form New Best-Friendships from Those Who Do Not.

Three groups were identified using best-friendship nominations at two time points surrounding the transition to middle school (Time 1: Spring of 5th grade; Time 2: Fall of 6th grade): (i) children who had no best-friendship at Time 1, but had a best-friendship at Time 2 (best-friendship gain; N=109); (ii) children who had no best-friendship at either Time 1 or 2 (chronically best-friendless; N=105); and (iii) children with a best-friendship at both Times 1 and 2, but with different peers at each time (best-friendship change; N=120). Peer nominations of social behaviors and victimization were collected at Times 1 and 2. Findings suggest that attraction to similar others, in addition to increased displays of prosocial behaviors, facilitate the formation of new best-friendships for both initially best-friendless and best-friended children.

The Distinctive Difficulties of Disagreeable Youth.

This study examines whether disagreeable youth are distinct from aggressive youth, victimized youth, and withdrawn youth. Young adolescents (120 girls and 104 boys, M = 13.59 years old) completed personality and adjustment inventories. Aggression, withdrawal, and victimization scores were derived from peer nominations (N = 807). Cluster analyses identified six groups. Disagreeable youth, aggressive victimized youth, withdrawn victimized youth, and withdrawn youth tended to have worse concurrent peer relations than did agreeable youth and aggressive youth. Disagreeable youth had some of the highest levels of concurrent and prospective adjustment problems, with rates of self-and mother-reported internalizing problems that rivaled withdrawn victimized youth and withdrawn youth, and rates of self-and mother-reported externalizing problems that rivaled aggressive victimized youth and aggressive youth. The findings indicate that low agreeable youth represent a discrete category of adolescents with social and adjustment difficulties.

Breadth and intensity: salient, separable, and developmentally significant dimensions of structured youth activity involvement.

In recent years, an impressive volume of evidence has accumulated demonstrating that youth involvement in structured, organized activities (e.g. school sports, community clubs) may facilitate positive youth development. We present a theory-based framework for studying structured activity involvement (SAI) as a context for positive youth development based on two key dimensions: breadth and intensity of involvement. Our main goal is to demonstrate the separability, salience, and developmental significance of these two dimensions. We review three developmental theoretical approaches (identity development, life-span selection-optimization-compensation theory, and affordances) that support our conceptualization of breadth and intensity as salient and significant dimensions of SAI. We also summarize our recent program of research on SAI demonstrating the separability of breadth and intensity dimensions, which shows links between these dimensions and indicators of positive development. Finally, we discuss how the proposed breadth-intensity approach could be used to extend research on the linkage between youth SAI and successful development.