‘Reach Out,Rise Up’: The efficacy of text messaging in an intervention package for anxiety and depression severity in young people

BackgroundDepression and anxiety are among the most commonly experienced mental health issues faced by young people in Aotearoa, New Zealand. Considerable barriers exist that prevent young people from engaging with face-to-face mental health services. Young people's preference for technology-based counselling mediums such as text messaging opens up new pathways for intervention.ObjectiveA pilot text message-based intervention package was trialled for use by young people to evaluate the potential efficacy of the text package as an intervention for depression and anxiety symptoms.MethodThe text package was piloted using a 10-week longitudinal cohort pilot with 21 young participants (12–24 years) who demonstrated mild to moderate anxiety and/or depression symptoms.ResultsParticipants' post-package scores were significantly lower than their pre-package scores for both anxiety (Z = − 2.83, p = .005, r = − 0.65) and depression (Z = − 2.49, p = .013, r = −.056). ‘Feeling encouraged and supported’ increased as a result of receiving support from a trained supporter (Z = − 2.06, p = .039, r = − 0.45), but not from friends/family (Z = − 1.72, p = .130, r = − 0.37). Anxiety and depression scores did not change as a result of support from either trained supporters or friends/family.ConclusionsFindings support the potential efficacy of the text package, justify wider trials of the text package, and support the use of text message-based interventions as potentially effective therapies for young people.     

The development of adolescents’ friendships and antipathies: A longitudinal multivariate network test of balance theory

We examined the interplay between friendship (best friend) and antipathy (dislike) relationships among adolescents (N = 480; 11–14 years) in two US middle schools over three years (grades 6, 7, and 8). Using longitudinal multivariate network analysis (RSiena), the effects of friendships on antipathies and vice versa were tested, while structural network effects (e.g., density, reciprocity, and transitivity) and individual (age, gender, and ethnicity) and behavioral (prosocial and antisocial behavior) dispositions were controlled for. Based on (structural) balance theory, it was expected that friendships would be formed or maintained when two adolescents disliked the same person (shared enemy hypothesis), that friends would tend to agree on whom they disliked (friends’ agreement hypothesis), that adolescents would tend to dislike the friends of those they disliked (reinforced animosity hypothesis), and, finally, that they would become or stay friends with dislikes of dislikes (enemy's enemy hypothesis). Support was found for the first three hypotheses, and partially for the fourth hypothesis. Results are discussed in light of adolescents’ peer relationships.     

How an intervention project contributes to social inclusion of adolescents and young people of foreign origin

This article presents the results of the impact study of the Nightingale Project, a social mentoring project, whose aim is to support the welcoming and social inclusion processes of adolescent students of foreign origin who recently arrived in Catalonia and who are currently enrolled in the country's schools. The more than one hundred mentoring pairs (mentor and mentee) that took part in the intervention project were administered a questionnaire (N = 58). This same questionnaire was also given to a group of adolescents with the same profile but who did not participate in the project (N = 128) and who were treated as a control group.After six months of intervention (which corresponds to the duration of the Nightingale Project), results show that students who participate in mentoring learn the language faster, create broader and more diverse networks of friends in school, develop higher educational aspirations and expectations, are better acquainted with the reception context (municipality they live in), and improve standards of self-confidence and self-esteem, among other characteristics. The research also demonstrates that mentoring aimed at adolescents, as is the case of the Nightingale Project, plays a key role in avoiding development of an oppositional identity and, conversely, helps facilitate a process of resilience in adolescents in the new context of reception.     

Services use by children and parents in multiproblem families

BackgroundMultiproblem families are multi-users of psychosocial and health care services, but little is known about factors associated with their care utilization in the general population. The aim of this study was to assess which factors were associated with the overall and psychosocial care use of two members—i.e., child and parent—of each multiproblem family.MethodsDuring well-child visits or psychosocial care, we identified 354 children and their parents who had problems in several life domains (response 69.1%). We used multivariate stepwise backward logistic regression analyses to identify the factors related to their use of overall and psychosocial care.ResultsA child's overall care use was associated with greater social support from family and friends (odds ratio, OR, 95% confidence interval, CI; OR = 1.05, CI = 1.01–1.08) compared to less perceived social support; and with more psychosocial problems in the child (OR = 1.84, CI = 1.04–3.24). Child's psychosocial care use was more likely among older children (OR = 1.94, CI = 1.20–3.15); greater social support by family and friend (OR = 1.03, CI = 1.00–1.06); more psychosocial problems (OR = 1.75, CI = 1.04–2.97); and when there were more parenting concerns (OR = 1.19, CI = 1.06–1.33). Parental overall and psychosocial care use was more likely when the family experienced a higher number of life events (OR = 1.27, CI = 1.17–1.38, and OR = 1.39, CI = 1.25–1.55).ConclusionsCare use in multiproblem families is related to family factors as well as psychosocial problems. It may be possible to use these family risk factors to identify such families early, whose intensive care use is possibly explained by the relationship with inadequate use of social support.     

Heterogeneity among adolescent mothers and home visiting program outcomes

Despite the challenges of early parenting, many adolescents navigate motherhood successfully, underscoring an overlooked heterogeneity among adolescent mothers. The present study used Latent Class Analysis (LCA) to identify subgroups of adolescent mothers (n = 704) enrolled in a randomized controlled trial (RCT) evaluation of a home visiting program for young parents. The model incorporated demographic and background characteristics, as well as indicators of psychological vulnerability. Analyses revealed four distinct subgroups: (a) non-Hispanic high vulnerability (n = 209, 30%); (b) Hispanic high vulnerability (n = 98, 14%); (c) non-Hispanic moderate vulnerability (n = 241, 34%); and (d) Hispanic moderate vulnerability (n = 156, 22%). Mothers in the two high vulnerability subgroups exhibited the poorest personal and parenting functioning outcomes measured approximately two years postpartum, particularly in terms of child maltreatment (non-Hispanic high vulnerability) and depressive symptoms (Hispanic high vulnerability). Analyses revealed positive effects of the home visiting program within specific latent classes on such outcomes as healthy baby at birth, high school or GED attainment, and repeat birth.     

Adolescents at risk and their willingness to seek help from youth care workers

Youth care workers (YCWs) are educational-therapeutic workers in nonformal community educational settings for adolescents at risk. This study examines the way adolescents at risk perceive YCWs, and their willingness to seek help (WISH) from them as compared to parents, friends, and teachers, and the variables that explain their willingness. The participants (N = 211, age 14–18), in youth care units, answered self-report questionnaires about their personal characteristics and their WISH from each of the four sources. Findings showed that YCW was ranked lower than friends – and similar to parents – and well above teachers. The factors that explain why participants turn to YCW are similar to those explaining turning to the other three sources examined, with source identity and its nonformal attributes (e.g., proximity, reliability, and willingness to help) being most influential. Additionally, the higher one's willingness for self-exposure, the higher is their willingness to turn to the sources examined.     

Comparing family,friends and satisfaction with school experience as predictors of SWB in children who have and have not made the transition to middle school in different countries

Transition to middle school periods is especially vulnerable stages in which children need external support to facilitate their adaptation to middle education. In this regard, this study aims at observing how the social supports “family” and “friends” influence SWB before and after the transition to middle school. This is conducted taking into account the mediating effect of satisfaction with school experience in a stage where significant changes occur in the school setting. To this end, different countries that have in common a transition to middle school period taking place between 10 and 12 years old are selected. Two structural models were conducted, one for 10-year-old children and other for 12-year-old children. Both samples included 8923 participants from 4 countries (Chile, South Korea, USA and Algeria). The mean age of participants was 11.20 years (SD = 1.12).The overall analysis of the results from the two models indicates that support agents (family and friends) are significant to SBW before and after the transition to middle school period. In concrete, friend support is more important than family support to 10 and 12-year-old children. Nevertheless, satisfaction with school experience behaves as a mediator between friend support, family support and SWB, and has the greatest effect on SWB at both ages. Finally, differences observed in the invariance analysis across different countries are discussed.     

Familism and depressive symptoms among Italian adolescents: The mediating effect of parental attachment

Familism refers to “a culturally grounded way of valuing family that emphasizes an ideal for family relationships to be warm, close, and supportive and that family be prioritized over self”. It is considered a core value of Latino culture and a crucial protective factor of psychological health among Latino populations. However, scant research has addressed the possible value of familism and the association between familism and psychological health and the underpinning mechanisms among Italian adolescents. The current study aimed to test the relation of familism to depressive symptoms and the mediating effect of parental attachment in an Italian adolescent sample. Participants (N = 513) completed self-report measures assessing familism, parental attachment, and depressive symptoms. Results of the total effect model showed that familism was negatively related to depressive symptoms. In the indirect effect model, it was found that the relationship between familism and depressive symptoms was mediated by both maternal attachment and paternal attachment. Moreover, results of multi-group path analyses revealed that the associations among familism, parental attachment, and depressive symptoms did not differ by sex but by developmental period (i.e., early- vs. middle adolescence). In conclusion, this research suggests the protective role of familism in Italian adolescents' depressive symptoms.     

Parental Influence on Friendships Between Native and Immigrant Adolescents

Parental influence on friendships between native (N = 5,683) and immigrant (N = 3,371) adolescents (aged ± 15) was investigated with the CILS4EU data of pupils in German and Dutch school classes (N = 446) and parents. The researchers examined whether parents affect friendships across group boundaries by shaping the structural opportunities to establish out‐group friends and their children's out‐group attitudes. The results show that if parents have more out‐group friends and if they consider it less important to maintain in‐group traditions, their children have more out‐group friends. Part of this relationship is mediated by children's out‐group attitudes. Some evidence is found that the opportunity structure mediates the relationship between parental characteristics and adolescent out‐group friendship.     

Concurrent alcohol and cigarette use among school-going adolescents in Korea

BackgroundConrurrent alcohol and tobacco use may increase the risk for substance abuse in adolescents. The aim of this study was to investigate concurrent alcohol and cigarette use and the co-occurrence risks of each substance in school-going adolescents in Korea.MethodsIn a cross-sectional nationally representative survey in 2016, 65,528 students (Mean age = 15.1 years, SE = 0.02) responded to a questionnaire that included measures of substance use and substance use exposure.ResultsIn all, 13.3% of the students were concurrent lifetime smokers and drinkers (19.3% among boys and 6.7% among girls), 25.5% lifetime alcohol users only (24.2% among boys and 26.9% among girls), 3.0% lifetime smokers only (4.7% among boys and 1.1% among girls) and 58.3% never smoked and never used alcohol (52.2% among boys and 47.8% among girls). All measures of more intensive smoking pattern and smoking exposure and more intensive drinking pattern and drinking exposures, respectively, were associated with consistently increased risk of lifetime alcohol use and lifetime smoking, respectively, compared to lifetime never smokers and abstainers. In multinomial logistic regression, compared to students who neither had used alcohol nor tobacco, concurrent lifetime smokers and drinkers were more likely to be male, mixed or boys school, higher school grade, lower paternal and maternal educational level, perceived lower socio-economic status, ever drug user, perceived stress above average, depressive mood, experience of violence victimization, and living in a rural area or medium sized city.ConclusionPrevention and treatment strategies should better incorporate the comorbidity of cigarette smoking and alcohol use in their intervention programmes.     

Association between social support and child abuse potential among Japanese mothers

Child abuse is a global public health problem and a serious social issue in Japan. Social support is beneficial for parents faced with childrearing challenges. The aim of this study was to clarify the association between social support and child abuse potential. A cross-sectional study was conducted using a structured questionnaire. The target population was mothers of children at nine public nursery schools. Bivariate and multiple linear regression analysis were performed to examine the effects of socio-demographic, social support and psychological distress factors on child abuse potential. Among 309 mothers, 29 (9.4%) had a high child abuse potential score. Bivariate analysis indicated that mothers with a higher child abuse potential score were more likely to be divorced or unmarried (P < 0.001); living in single-female-parent households (P < 0.001); have low perceived economic status (P < 0.001); have a low level of child care support (P = 0.01); have a low Multidimensional Scale of Perceived Social Support (MSPSS) score (P < 0.001); and/or a high General Health Questionnaire-12 score (GHQ-12) (P < 0.001). Important predictors of child abuse potential among the mothers surveyed included living in single-female-parent households, having low perceived economic status, low MSPSS score, and high GHQ-12 score. Improving approaches that help mothers build social support relationships and ease them into child rearing in a psychologically healthy condition is recommended to prevent child abuse.     

Cigarette,alcohol, and marijuana use among adolescents in foster family homes

Data from a cross-sectional study conducted in a random sample of children who were placed in foster family homes were used to examine the prevalence and associated factors of substance use (i.e., cigarette, alcohol, and marijuana), and to explore if adolescents in foster family homes had different rates of substance use than those in the general population matched on age, gender and race/ethnicity. Logistic regression models were used to determine factors associated with substance use and McNemar tests were used to compare prevalence rates of substance use. Substance use was common among adolescents in foster family homes. A higher number of placement settings were significantly associated with current cigarette use (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.09–1.60), and being placed in special study homes (i.e., fictive kin) was significantly associated with current marijuana use (OR, 6.43; 95% CI, 1.40–29.52). Compared to adolescents in the general population, those in foster family homes had lower rates of current alcohol (9.1% vs. 38.3%, p < 0.0001) and marijuana (13.6% vs. 29.7%, p = 0.005) use. No significant difference was observed for current cigarette use (18.2% vs. 11.5%, p = 0.08). More research is needed to confirm the lower rate of current substance use in foster family homes than those matched in the general population, and to explore why adolescents in special study homes were more vulnerable to marijuana use.     

Parental emotional warmth and psychological Suzhi as mediators between socioeconomic status and problem behaviours in Chinese children

ObjectiveThis study investigated psychological mechanisms underlying the relationship between family socioeconomic status (SES) and problem behaviours in Chinese children.MethodsParticipants were 1128 children (556 females) from two Chinese elementary schools, aged 8–13 years (M = 10.82, SD = 1.26), attending the 3rd–6th grades. Children provided self-report on parental emotional warmth and psychological suzhi, whereas parents reported on SES and problem behaviours.ResultsData analyses, including structural equation modelling (SEM)—employed to test a three-path mediation effect of parental emotional warmth and psychological suzhi after controlling for gender and grade—revealed that: (1) SES, parental emotional warmth, and psychological suzhi were negatively correlated with children's problem behaviours; (2) SES indirectly affected children's psychological suzhi through parental emotional warmth; (3) psychological suzhi mediated the relation between parental emotional warmth and problem behaviours; and (4) children belonging to families with low SES were less likely to receive emotional support from their parents. This significantly predicted low psychological suzhi levels, which in turn negatively affected problem behaviours.ConclusionsStrategies that help parents provide warmth and support and those that help children improve psychological suzhi may help reduce problem behaviours in vulnerable groups.     

A comparison of widowhood and well-being among older Greek and British-Australian migrant women

The impact of widowhood on well-being has been well-documented, but to date has not focused extensively on the experience of older migrants who have aged in a foreign land. This study aimed to examine the well-being of older migrant widows from two groups in South Australia: British-born (n = 61) and Greek-born (n = 60) Australian migrants, who had been widowed, on average, 13 years. All participants completed a self-report questionnaire in their preferred language. Three indicators of current well-being (self-rated health, depression and loneliness) as well as variables expected to differ cross-culturally, and potentially influence well-being (mourning rituals; continuing bonds to one's spouse; religiosity; social support) were measured. Greek-born widows displayed higher levels of mourning rituals, continuing bonds and religiosity than the British. Both groups perceived similarly high levels of familial social support. Greek widows also reported worse self-rated health, and increased symptoms of depression and loneliness compared to the British. This paper suggests that the detrimental impact of widowhood on well-being may be greater for non-English speaking migrants who are ageing outside of their country of origin, and who, despite residing in an English-speaking host country for several decades, have retained the linguistic, cultural and religious practices and traditions of their home country.     

Abuse, support, and depression among homeless and runaway adolescents

This study examines the effectiveness of social support networks on psychological well-being among 602 homeless and runaway adolescents. The respondents were interviewed in shelters, drop-in centers, and on the streets in cities of four Midwestern states (Missouri, Iowa, Nebraska, and Kansas). The path model was used to test the direct effect of family abuse and precocious independence on adolescent depressive symptoms and indirect effects through social support networks. Results indicate that although abusive family origins contribute directly to depressive symptoms there are indirect effects of family abuse and early independence through social support networks. Family abuse and early independence drive homeless adolescents to rely on peers for social support. While support from friends on the street reduces depression, association with deviant peers increases depression.     

Determinants of tobacco use among Korean female adolescents: Longitudinal test of the theory of triadic influence

This study aimed to examine the influences of social, attitudinal, and intrapersonal factors at three levels on tobacco use among female adolescents in South Korea using longitudinal national data. The study analyzed data from the Korean Youth Panel Study, with a study population consisting of middle-school second-graders (N = 1594). Using time dependent Cox regression, our analyses yielded the following main findings: the theory of triadic influence was verified to provide a theoretical framework for smoking among Korean female adolescents. All of the social factors at the three levels, including parental supervision, attachment to friends, and peer smoking prevalence, were found to influence tobacco use among Korean female adolescents. Stigma on the distal level and attitude towards smoking on the proximal level were significant attitudinal factors. Among intrapersonal factors, self-control on the distal level and stress on the proximal level were found to be significant. The study findings suggest that including parental education and promoting attachment to non-smoking friends, as well as enhancing sound relationships with them, would provide an effective strategy for the prevention and cessation of smoking. Prevention and cession should include strategies that alleviate stigma and stress, and improve negative attitude toward smoking and the level of self-control.     

Development of an innovative process evaluation approach for the Families Improving Together (FIT) for weight loss trial in African American adolescents

This study demonstrates how a multi-theoretical, multilevel process evaluation was used to assess implementation of the Families Improving Together (FIT) for weight loss intervention. FIT is a randomized controlled trial evaluating a culturally tailored, motivational plus family-based program on weight loss in African American adolescents and their parents. Social Cognitive, Self Determination, Family Systems theories and cultural tailoring principles guided the conceptualization of essential elements across individual/family, facilitator, and group levels. Data collection included an observational rating tool, attendance records, and a validated psychosocial measure.ResultsAttendance records (0 = absent, 1 = present, criteria = ≥70%) indicated that 71.5% of families attended each session. The survey (1 = false, 6 = true, criteria = ≥4.5) indicated that participants perceived a positive group climate (M = 5.16, SD = 0.69). A trained evaluator reported that facilitator dose delivered (0 = no, 1 = yes, criteria = ≥75%) was high (99.6%), and fidelity (1 = none to 4 = all, criteria = ≥3) was adequate at facilitator (M = 3.63, SD = 0.41) and group levels (M = 3.35, SD = 0.49). Five cultural topics were raised by participants related to eating (n = 3) and physical activity (n = 2) behaviors and were integrated as part of the final curriculum.DiscussionResults identify areas for program improvement related to delivery of multi-theoretical and cultural tailoring elements. Findings may inform future strategies for implementing effective weight loss programs for ethnic minority families.     

Cooks training for Faith,Activity, and Nutrition project with AME churches in SC

PurposeThis study describes the development and evaluation of a participatory training for cooks in African American churches.The 8-h training focused on providing healthy meals within the church food program. It enlisted cooks in hands-on “cooking with the chef” training and menu building exercises, and demonstrated development of flavor in foods through healthy ingredients. Cook ratings from pre- to post-training (possible range: 1–10) were evaluated with the Wilcoxon signed rank test.Results114 cooks from 57 churches over the period from 7/21/07 to 3/21/11 participated in trainings. Self-rated cooking skill increased from pre- (6.5 ± SD) to post-training (7.9 ± SD), p = 0.0001. Self-rated confidence in preparing meals also increased significantly (pre: 7.3 ± SD; post: 8.3 ± SD), p = 0001.Qualitative feedback from the cooks’ training has been positive. Two of the more frequently stated changes cooks report are using less salt and using more vegetables and fruits in menus. Lessons learned include: choosing the right church to host the training, teamwork as a key component, need for support system for church cooks, allocation of time for planning as well as shopping for healthy ingredients, and incorporation of flexibility into the training plan.     

Parental and peer attachment and adolescents' behaviors: The mediating role of psychological suzhi in a longitudinal study

We examined whether psychological suzhi mediated the associations between attachment (paternal, maternal, and peer) and young adolescents' behavior (internalizing, externalizing, and prosocial) in a longitudinal study. Psychological suzhi reflects the positive psychological traits that facilitate adolescents' positive adaptation to the school and social environment. Five hundred and ninety-five junior high school students (48% male; aged 11–15 years, M = 12.86 years, SD = 0.71) completed measures of attachment and psychological suzhi at Times 1 and 2 (a six-month interval), while students' parents completed measures of adolescents' behavior at Time 3 (another six months later). We observed significant longitudinal correlations between attachment, psychological suzhi, and behavior. Prospective analyses using bootstrapping demonstrated significant indirect effects of attachment on adolescent behavior via psychological suzhi. These findings highlighted the importance of attachment and psychological suzhi as protective factors in the developmental course of early adolescents' behavior.     

Community-based organizations for vulnerable children in South Africa: Reach,psychosocial correlates,and potential mechanisms

Community-based organizations (CBOs) have the potential to provide high quality services for orphaned and vulnerable children in resource-limited settings. However, evidence is lacking as to whether CBOs are reaching those who are most vulnerable, whether attending these organizations is associated with greater psychosocial wellbeing, and how they might work. This study addressed these three questions using cross-sectional data from 1848 South African children aged 9–13. Data were obtained from the Young Carers and Child Community Care studies, which both investigated child wellbeing in South Africa using standardized self-report measures. Children from the Child Community Care study were all CBO attenders, whereas children from Young Carers were not receiving any CBO services, thereby serving as a comparison group. Multivariable regression analyses were used to test whether children attending CBOs were more deprived on socio-demographic variables (e.g., housing), and whether CBO attendance was in turn associated with better psychosocial outcomes (e.g., child depression). Mediation analysis was conducted to test whether more positive home environments mediated the association between CBO attendance and significantly higher psychological wellbeing. Overall, children attending CBOs did show greater vulnerability on most socio-demographic variables. For example, compared to children not attending any CBO, CBO-attending children tended to live in more crowded households (OR 1.22) and have been exposed to more community violence (OR 2.06). Despite their heightened vulnerability, however, children attending CBOs tended to perform better on psychosocial measures: for instance, showing fewer depressive symptoms (B = − 0.33) and lower odds of experiencing physical (OR 0.07) or emotional abuse (OR 0.22). Indirect effects of CBO attendance on significantly better child psychological wellbeing (lower depressive symptoms) was observed via lower rates of child abuse (B = − 0.07) and domestic conflict/violence (B = − 0.03) and higher rates of parental praise (B = − 0.03). Null associations were observed between CBO attendance and severe psychopathology (e.g., suicidality). These cross-sectional results provide promising evidence regarding the potential success of CBO reach and impact but also highlight areas for improvement.