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Adolescence is a strategic developmental stage in terms of preventing later difficulties and ensuring good mental health. Prophylactic interventions, which are conducted before the onset, prolongation, or worsening of difficulties, and aim to prevent or reduce symptoms or to promote wellbeing, therefore appear particularly appropriate for adolescents. However, existing prophylactic interventions conducted with adolescents have several weaknesses, including sparse theoretical frameworks, ambivalent evidence of their efficacy, and implementation and dissemination difficulties. In addition, no data are currently available on the effectiveness of such interventions in France. To fill this gap, a four-arm randomized controlled trial will be performed to assess the effectiveness of three prophylactic interventions targeting reactive, proactive and interpersonal adaptation in fourth-grade middle-school students, together with participants' experience and perception of the interventions. Based on existing knowledge about adolescents, their learning mechanisms, and field constraints, these three interventions have been designed to promote their learning and receptiveness to interventions. Compared with baseline (i.e., before the intervention), we expect to observe a significant decrease in the level of distress (anxiety and depressive symptoms, functional impairment, and psychosocial difficulties) and a significant increase in the level of wellbeing after the intervention, across the three intervention groups, but not in the control group. In addition, we expect to observe post-intervention improvements in the processes targeted by the reactive adaptation intervention (operationalized as coping strategy use and flexibility), those targeted by the proactive adaptation intervention (operationalized as the tendency to engage in committed actions and general self-efficacy), and those targeted by the interpersonal adaptation intervention (operationalized as assertiveness in interactions), but only in the corresponding groups, with no change in any of these processes in the control group. The results of this research will not only enrich our knowledge of the processes involved in adolescents' distress and wellbeing, but also provide clues as to the best targets for intervention. Moreover, the material for these interventions will be freely available in French on request to the corresponding author, providing access to innovative and fully assessed interventions aimed at promoting adolescents' mental health in France. This clinical trial is currently being registered under no. 2023-A01973-42 on https://ansm.sante.fr/. This is the first version of the protocol. [ABSTRACT FROM AUTHOR]

Background: Students are a priority population in mental health research. This study aimed to explore the risk factors of anxiety and depression symptoms among college students in Chongqing, a megacity under the impact of COVID-19, and to provide a basis for determining the priorities of public health policies and implementing effective educational health care interventions. Methods: In this cross-sectional study conducted in Chongqing, China, the data came from web-based stratified random sampling. Anxiety and depression symptoms were measured by the Self-Rating Anxiety Scale (SAS) and the Center for Epidemiological Studies Depression Scale (CES-D), respectively, and risk factors were analyzed by logistic regression. Results: Data were obtained from 915 college students (34.75% were male, and 65.25% were female) with age (20.29 ± 1.51) in Chongqing, China. The prevalence rates of anxiety and depression were 19.78% and 22.62%, respectively. Logistic regression analysis revealed that the risk factors of anxiety symptoms were associated with junior years, sleep time of less than 6 h a day, influence on career planning, and depression symptoms. Comprehensive, science and engineering, and medicine disciplines, having siblings, poorer mastery of study, and anxiety symptoms were risk factors for developing depression symptoms. Conclusions: During the pandemic, college students experienced varying degrees of anxiety and depression. Our research findings highlight the necessity of universities and relevant departments providing precise mental health education for college students under major public health emergencies. [ABSTRACT FROM AUTHOR]

Background: Self-discrepancy is associated with poorer mental health, yet its mechanism is understudied. A recent study found that resilience plays a moderating role in the relationship between self-discrepancy and depressive symptoms in adults. The current study investigated whether there were any similar relationships among young people aged 15 to 24 years. Methods: As part of the ongoing Hong Kong Epidemiological Study of Mental Health (HK-YES) project, the current study analysed data from 1,144 participants who provided complete data on ideal-actual selfdiscrepancy, psychiatric conditions, resilience level and recent stressful life events (SLEs). Results: Ideal-actual self-discrepancies were associated with increased depressive and anxiety symptoms, as well as odds of 12-month major depressive episodes (MDEs) and generalised anxiety disorder (GAD). All these associations became nonsignificant after adjusting for resilience. Separate models found resilience mediating rather than moderating the relationship. According to four-way decomposition, the pure indirect effect explained most of the total effects of self-discrepancy on mental health conditions. The mediation effects on symptom severity were recently revealed to be more prominent among individuals with substantial exposure to SLE. Conclusions: Resilience functions mainly as a mediator in the relationship between self-discrepancy and mental health conditions, and its effect is weakened by the exposure of SLEs. Important implications are discussed regarding the use of resilience-focused interventions and the consideration of recent adversity. [ABSTRACT FROM AUTHOR]

Anxiety disorders are among the most prevalent psychopathologies in Western adolescents and have been on the rise in recent years. Not only does anxiety disrupt the daily lives of the young people who suffer from it, it can also have harmful behavioral, psychological, social, and academic effects. Given this, there is a pressing need to implement universal anxiety prevention programs for adolescents in one of their main living environments, the school. This type of program has the twofold advantage of reaching all adolescents before the onset of more significant symptoms and of promoting access to services for young people in difficulty. This study aimed to evaluate the effects of the HORS‐PISTE—Exploration Cycle 1 program developed by the RBC Center for Academic Expertise in Mental Health, based on the initial level of problems presented by the students, using a preexperimental pretest–posttest design. A total of 2276 students in grades 7 and 8, with an average age of 12.65 years, from 16 high schools participated in the pretest and posttest evaluations. The results showed that the students who participated in the HORS‐PISTE program reported a significant change in the intended direction for several of the variables examined between T1 and T2. In particular, decreases in anxiety symptoms, fear of being judged by others, perfectionism, internet addiction, intolerance of uncertainty, and anxiety interference, as well as an increase in the sense of self‐efficacy, were observed between T1 and T2 for both boys and girls. The results also showed that students who presented at T1 with more significant anxiety symptoms and proximal risk factors experienced greater improvement than did those with a moderate or low level of initial problems. Overall, the results of this evaluative study of the HORS‐PISTE program are promising, demonstrating positive changes in symptoms and in the main proximal risk factors for anxiety, in particular among students who initially presented with high levels of problems. This study therefore demonstrates the relevance of implementing this type of prevention program in high schools. Practitioner points: Participation in the HORS‐PISTE program is associated with a decrease in anxiety symptoms, fear of judgment by others, perfectionism, internet addiction, intolerance of uncertainty, and anxiety interference.The changes observed as a result of participating in the HORS‐PISTE program are observed in both boys and girls.The results of this study showed that the HORS‐PISTE program appears to be particularly effective for students who initially had higher levels of anxiety. [ABSTRACT FROM AUTHOR]

Anxiety problems are common in children and can have profound adverse effects on personal, social and academic life. Almost 40% of anxiety disorders emerge before age 14, making primary schools invaluable settings for prevention and early support of child anxiety. Research indicates that school‐based interventions can be costly and difficult to schedule, school staff lack confidence to deliver them effectively, and outcomes are mixed. One solution may be for school staff to adapt and enhance their day‐to‐day practices to better support children with anxiety. This systematic review aims to summarise what is known about the relationship between teachers' classroom management and anxiety in primary school‐aged children. We searched ASSIA, British Education Index, Education Abstracts, Embase, ERIC, MEDLINE, PsycINFO and Scopus in December 2020 and June 2022, using a predefined strategy. We included studies of any design, published in peer‐reviewed journals at any time, in any language, reporting associations between day‐to‐day classroom management strategies/methods and anxiety/internalising outcomes in children aged 4–11 years, taught in mainstream primary schools. Studies were assessed for quality/risk of bias. We identified eight studies (six quantitative, two qualitative) including 4505 children. We found some evidence that authoritarian, controlling and punitive classrooms may be linked to higher levels of anxiety, although, overall, existing evidence indicates either a weak or no association between classroom management and anxiety. This review highlights a paucity of research in this area. Furthermore, variability in design, measures and quality makes drawing firm conclusions difficult. Recommendations for future research are discussed. Context and Implications: Rationale for this study: This review explores what is currently known about the relationship between teachers' day‐to‐day classroom management practices and anxiety in primary school‐aged children. Why the findings matter: Anxiety problems are common and often start in the primary years, however there is scant evidence to inform primary school educators on how day‐to‐day classroom practices can be used to better support children with or at risk of anxiety problems. Implications for researchers and practitioners: This review is relevant for primary classroom practitioners, school leaders, education professionals, academics, researchers and policymakers keen to better understand how to support those with or at risk of anxiety. Although overall findings indicate very small associations between teaching styles/practices and anxiety in children, there is very little research to draw on. Research is urgently needed that uses robust designs to focus on whether specific, feasible, day‐to‐day strategies can be used by school staff to effectively manage and minimise children's anxiety problems and, if so, how school staff can best be supported and equipped to deliver them. [ABSTRACT FROM AUTHOR]

The availability of digital tools aiming to promote adolescent mental health is rapidly increasing. However, the field lacks an up-to-date and focused review of current evidence. This study thus looked into the characteristics and efficacy of digital, evidence-based mental health programs for youth (11–18 years). The selection procedure followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and resulted in 27 eligible studies. The high heterogeneity of the results calls for careful interpretation. Nevertheless, small, but promising, effects of digital tools were found with respect to promoting well-being, relieving anxiety, and enhancing protective factors. Some important factors influencing overall efficacy include the given setting, the level of guidance and support, and the adherence to the intervention. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic and its accompanying infection control measures introduced sudden and significant disruptions to the lives of children and adolescents around the world. Given the potential for negative impacts on the mental health of youths as a result of these changes, we conducted a systematic review and meta‐analysis to examine the prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances in children and adolescents during the pandemic. We searched major literature databases for relevant cross‐sectional or longitudinal studies that included primary and secondary school students or children and adolescents ≤18 years of age. Prevalence values were extracted, logit‐transformed, and pooled. Based on 191 included studies with 1,389,447 children and adolescents, we found the pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances to be 31%, 31%, and 42%, respectively. Age, grade levels, education levels, gender, geographical regions, and electronics use were correlated with the prevalence of mental health symptoms. The prevalence of mental health symptoms also increased with time, although signs of recovery and stabilization were also observed. Overall, the results from this review demonstrate the need for increased mental health research, monitoring, and intervention for children and adolescents during the current and future pandemics. [ABSTRACT FROM AUTHOR]

Resilience is learnable and broadly described as an individual's adaptive coping ability, its potential value for stress reduction must be explored. With a global coronavirus pandemic, innovative ways to deliver resilience training amidst heightened mental health concerns must be urgently examined. This systematic review aimed to (1) evaluate the effectiveness of digital training for building resilience and reducing anxiety, depressive and stress symptoms and (2) to identify essential features for designing future digital training. A three‐step search was conducted in eight electronic databases, trial registries and grey literature to locate eligible studies. Randomised controlled trials examining the effects of digital training aimed at enhancing resilience were included. Data analysis was conducted using the Stata version 17. Twenty‐two randomised controlled trials involving 2876 participants were included. Meta‐analysis revealed that digital training significantly enhanced the participants' resilience with moderate to large effect (g = 0.54–1.09) at post‐intervention and follow‐up. Subgroup analyses suggested that training delivered via the Internet with a flexible programme schedule was more effective than its counterparts. This review supports the use of digital training in improving resilience. Further high‐quality randomised controlled trials with large sample size are needed. [ABSTRACT FROM AUTHOR]

Objectives : Investigating protective and risk factors associated with depressive and anxious symptoms in youth is important. The current cross-sectional study aimed to explore the unique contributions of modifiable protective and risk factors associated with depressive and anxious tendencies and to identify the most important variables of this symptomatology in youth. Methods: We applied a stepwise multiple linear regression to the data of 424 youth aged 13 to 22, who completed depression, anxiety, social safeness, mindfulness, forgiveness, self-reassurance, anger control, positive and negative affect, self-inadequacy, self-hate and revenge measures. The strongest protective factors were extracted first, followed by the next strongest factor, while controlling for the combined effect of previously extracted factors, until no significant factors were identified. Results: Mindfulness, social safeness and self-reassurance were the strongest and the most relevant protective factors against depressive and anxious tendencies together explaining over 40% of variance in anxiety and over 30% in depression scores. After controlling for protective factors, risk factors explained 23% of variance in anxiety and 9% in depression with self-inadequacy, revenge and negative affect being the major risks. Conclusions: Our findings highlight the protective role of mindfulness, social safeness and self-reassurance against both depressive and anxious tendencies in youth, and the detrimental role of self-inadequacy and revenge. Future longitudinal studies could evaluate whether initially higher levels of mindfulness, self-reassurance and social safeness predict a decrease of depressive and anxious symptomatology over time and whether self-inadequacy and revenge predict depressive and anxious symptomatology over time. Such longitudinal investigations may inform the design and focus of experimental studies aiming at targeting depressive and anxious symptomatology in youth. [ABSTRACT FROM AUTHOR]

Secure attachment is fundamental to the development of resilience among adolescents. The present study investigated whether meditation and precept practices influence the relationship between attachment and resilience. This study recruited 453 10th–12th-grade boarding school students who completed the Experience of Close Relationship Questionnaire (revised), Resilience Inventory, Inner Strength-Based Inventory, and Precept Practice to assess attachment, resilience, meditation practice, and precepts adherence. The participants' mean age was 16.35 ± 0.96 years; 87.9% were females, and 89.2% were Buddhists. A parallel mediation model within the structural equation framework was used for an analysis of the indirect effect of attachment on resilience through meditation and precept practices. The indirect effects of attachment anxiety and avoidance on resilience were β = −0.086, 95% CI = −0.125, −0.054, p < 0.001, and β = −0.050, 95% CI = −0.088, −0.021, p = 0.006, respectively. The indirect effect size resulting from meditation was significantly higher than that resulting from observance of the precepts. The parallel mediation model explained the 33% variance of the resilience scores, compared with 23% from the direct effect of attachment anxiety and avoidance only. This work provides evidence that meditation and precepts significantly affect the relationship between attachment and resilience. [ABSTRACT FROM AUTHOR]