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Objective: Examine how executive functioning (EF), healthcare management, and self-efficacy relate to college students' health-related quality of life (HRQOL). Participants: Undergraduates completed questionnaires at baseline (Time 1; n = 387) and 18-24 months later (Time 2; n = 102). Methods: Participants reported on their EF and healthcare management skills at Time 1 and self-efficacy and mental and physical HRQOL at Time 2. Results: Students with fewer EF problems reported higher mental and physical HRQOL at both timepoints and those with higher healthcare management skills had higher mental and physical HRQOL at Time 1. Higher self-efficacy mediated the relation between EF and mental HRQOL, and the relation between healthcare management and mental HRQOL. Conclusions: Findings illustrate two potential pathways by which self-management, in healthcare settings or daily living, contributes to mental HRQOL during emerging adulthood. Assessing EF and healthcare management could help identify those at risk of low HRQOL and provide information that can inform interventions in college settings.

Objective: To examine the role of executive functioning (EF) in health self-management and the transition to adult health care among college students. Participants: A total of 378 undergraduate students from a public university participated in the study. Methods: Participants reported on EF, health self-management skills, and their readiness to transition to adult care. Mediation analyses were conducted to evaluate indirect effects of EF on readiness to transition via health self-management skills. Results: Students with greater EF difficulties were less ready to transition to adult care. Specific aspects of health self-management (Medication management/Appointment keeping) mediated the relationship between EF and readiness to transition. Conclusion: EF is a key developmental aspect of health self-management and transition readiness. Assessing EF strengths/weaknesses in students with suboptimal health self-management skills may provide valuable information for informing the development of individually-tailored transition plans in university health centers, thereby enhancing developmentally appropriate care during the college years.

Physiological synchrony, or concordance, among caregiver-child dyads involves the matching of biological states. Understanding this process is critical for enhancing our knowledge of the ways that the caregiver-child relationship supports child development. However, the meaning of physiological synchrony for child adjustment is poorly understood. This study examined physiological synchrony in respiratory sinus arrhythmia (RSA), an indicator of parasympathetic activity, between 87 mothers (M age = 35.30 years, SD = 6.71 years) and their preadolescent children (M age = 10.36 years, SD = 1. 19 years, 52.9% girls). Dyads, all of which were from economically impoverished backgrounds, participated in 3 tasks that varied in the level of interaction that was required between the partners. Mothers self-reported their own depressive symptoms and rated their children's externalizing and internalizing symptoms. Physiological synchrony was generally strongest in tasks requiring the greatest levels of interaction among partners. Further, RSA synchrony was positive in the context of low levels of maternal depressive and child internalizing symptoms, and negative in the context of high levels of such symptoms, though results varied by task. Child externalizing symptoms did not moderate the RSA concordance process. The results identify both proximal and distal contexts in which physiological synchrony occurs, which ultimately broadens our understanding of the meaning and significance of parent-child physiological synchrony.

Objective: To test potential cognitive and interpersonal moderators of two evidence-based youth depression prevention programs. Method: Two hundred four adolescents (Mage = 14.62 years, SD = 1.65; 56% female; 71% White, 11% Black, 11% multiracial, 5% Asian, 2% other races, 18% Hispanic/Latinx) were randomized to either a cognitive–behavioral (Coping With Stress [CWS]) or interpersonal (Interpersonal Psychotherapy–Adolescent Skills Training [IPT-AST]) prevention program. Potential moderators, selected based on theory and research, included rumination, negative cognitive style, dysfunctional attitudes, hopelessness, parent–adolescent conflict, negative interactions with parents and friends, and social support from parents and friends. Depression symptoms were assessed repeatedly through 18 months postintervention. Results: After adjusting for multiple comparisons, rumination (B = −2.02, SE =.61, p =.001, d =.47), hopelessness (B = −2.03, SE =.72, p =.005, d =.41), and conflict with father (B = 1.68, SE =.74, p =.02, d =.32) moderated intervention effects on change in depression symptoms from postintervention through 18-month follow-up. For example, at high levels of conflict with father, youth in IPT-AST reported a significant decrease in symptoms during follow-up, whereas youth in CWS reported a nonsignificant change in symptoms. At low levels of conflict with father, youth in IPT-AST reported a significant increase in symptoms during follow-up, whereas youth in CWS reported a nonsignificant change in symptoms. Conclusions: These exploratory secondary analyses of Personalized Depression Prevention study data highlight specific cognitive and interpersonal risk factors that could be considered when determining which prevention program may be most effective for a given adolescent. What is the public health significance of this article?: Adolescent depression is a major public health concern, and improving prevention efforts is critical. Study results suggest specific cognitive and interpersonal risk factors that may impact the effects of interventions for youth. [ABSTRACT FROM AUTHOR]

Objective The goal of the current study was to document patterns of stability and change in adolescent depression and suicide risk detected via universal depression screening in pediatric primary care and to determine who may go on to experience emerging risk. Methods Retrospective electronic health record information (sociodemographic data and depression screening results for 2 timepoints) was extracted for adolescents aged 12–17 who attended well-visits between November 15, 2017, and February 1, 2020, in a large pediatric primary care network. A total of 27,335 adolescents with 2 completed depression screeners were included in the current study. Results While most adolescents remained at low risk for depression and suicide across the 2 timepoints, others experienced emerging risk (i.e. low risk at time 1 but elevated risk at time 2), decreasing risk (i.e. high risk at time 1 but low risk at time 2) or stable high risk for depression or suicide. Odds of experiencing emerging depression and suicide risk were higher among adolescents who were female (compared to males), Black (compared to White), and had Medicaid insurance (compared to private insurance). Odds of experiencing emerging depression risk were also higher among older adolescents (compared to younger adolescents) as well as adolescents who identified as Hispanic/Latino (compared to non-Hispanic/Latino). Conclusions Findings can inform symptom monitoring and opportunities for prevention in primary care. [ABSTRACT FROM AUTHOR]

We identified common and unique barriers and facilitators of evidence-based suicide prevention practices across primary care practices with integrated behavioral health services and specialty mental health settings to identify generalizable strategies for enhancing future implementation efforts. Twenty-six clinicians and practice leaders from behavioral health (n = 2 programs) and primary care (n = 4 clinics) settings participated. Participation included a semi-structured qualitative interview on barriers and facilitators to implementing evidence-based suicide prevention practices. Within that interview, clinicians participated in a chart-stimulated recall exercise to gather additional information about decision making regarding suicide screening. Interview guides and qualitative coding were informed by leading frameworks in implementation science and behavioral science, and an integrated approach to interpreting qualitative results was used. There were a number of similar themes associated with implementation of suicide prevention practices across settings and clinician types, such as the benefits of inter-professional collaboration and uncertainties about managing suicidality once risk was disclosed. Clinicians also highlighted barriers unique to their settings. For primary care settings, time constraints and competing demands were consistently described as barriers. For specialty mental health settings, difficulties coordinating care with schools and other providers in the community made implementation of suicide prevention practices challenging. Findings can inform the development and testing of implementation strategies that are generalizable across primary care and specialty mental health settings, as well as those tailored for unique site needs, to enhance use of evidence-based suicide prevention practices in settings where individuals at risk for suicide are especially likely to present. We examined barriers and facilitators to suicide prevention across health settings. Common and unique barriers and facilitators across health-care settings emerged. Findings can enhance suicide prevention implementation across health-care settings. [ABSTRACT FROM AUTHOR]