Search

Encouraging involvement in school-based extracurricular activities (ECA) may be important for preventing high school dropout. However, the potential of these activities remains underexploited, perh...

The objectives of this study were to derive trajectories of childhood participation in organized physical activity (PA) and to examine how these trajectories are associated with pre-existing and subsequent emotional adjustment. Trajectories of mother-reported participation in organized PA were derived from age 6 to 10 for 1492 children from the Quebec Longitudinal Study of Child Development birth cohort. Parents and teachers reported on internalizing behavior (emotional distress, anxiety, shyness, social withdrawal) at ages 4 and 12, respectively. Longitudinal latent class analysis identified two typical trajectories of participation in organized PA. The Consistent Participation trajectory (61%) included children with elevated probability of participation at all ages. The Low-Inconsistent Participation trajectory (39%) included children who did not participate or participated only once or twice, generally in late childhood. Pre-existing internalizing behavior at age 4 did not predict trajectory membership. However, children in the Low-Inconsistent Participation trajectory showed higher subsequent emotional distress (B = 0.87, 95% confidence interval [CI] = 0.46–1.28), anxiety (B = 0.61, 95% CI = 0.18–1.04), shyness (B = 0.92, 95% CI = 0.39–1.44), and social withdrawal (B = 0.86, 95% CI = 0.37–1.34) at age 12 than those in the Consistent Participation trajectory. Our findings suggest that early and sustained involvement in organized PA is beneficial for children’s emotional development.

Most adolescent depression prevention programs have been tested in the USA and other Anglo-Saxon countries. Their effects in other contexts are less clear. We conducted a pilot trial aimed at testing the effectiveness of the Blues program, a brief indicated cognitive-behavioral (CB) group program to prevent depression originally developed in the USA, in French-Canadian secondary schools. CB group facilitators were endogenous school clinicians. A total of 74 students (mean age= 15.50; 66% female) with elevated depressive symptoms were randomized to CB group (n = 37) or educational brochure control (n = 37). Participants completed diagnostic interviews and surveys at pretest, posttest, and 6-month follow-up. Results showed that CB group had a large, statistically significant effect on MDD onset at 6-month follow-up. CB group also had a positive effect on depressive symptoms, intermediate outcomes (pleasant activities, negative thoughts), and one secondary outcome (improved interaction with parents) at posttest. These effects were not maintained at follow-up. This trial replicates results from a previous US effectiveness trial. The clinically meaningful effects of brief indicated CB group prevention, at least with regard to the prevention of MDD onset, hold in French-Canadian students when the intervention is implemented by school clinicians. Work is still needed to augment and maintain CB effects in real-world practice.

Background: Adolescent depression prevention programs are typically delivered in groups in which adolescents share a common setting and interventionist, but the influence of the group is usually ignored or statistically controlled. We tested whether the primary outcomes of reductions in depressive symptoms and future onset of major depressive disorder (MDD) varied as a function of group membership. Methods: Data were available from two randomized trials in which 220 adolescents received the Blues Program indicated prevention intervention in 36 separate groups, participants were assessed at baseline, post intervention, and at 6-, 12-, and 24-month follow-ups. Results: Ten percent of participants had developed MDD 2 years post intervention. Group-level effects for MDD onset over follow-up were nonsignificant (accounted for &lt, 1% of variance, ICC = 0.004, ns). Group-level effects for depressive symptom change across the follow-up period were also nonsignificant (ICC = 0.001, ns) but group effects accounted for 16% of depressive symptom change immediately post intervention (ICC = 0.159, p &lt, 0.05). Group-level clustering of posttest depressive symptoms was not associated with size of group or gender composition. Conclusions: Membership in specific adolescent cognitive-behavioral depression prevention groups may have an impact in terms of immediate symptom reduction but does not appear to have significant prevention effects in terms of long-term symptom change or MDD onset.

Background: Children, families and staff in pediatric hospitals often experience elevated psychological distress. Art-based initiatives, such as group drumming, have been proposed as strategies to ...

Connell and Wellborn's Self-System Model of Motivational Development (SSMMD; 1991) posits that structure, autonomy support, and involvement from teachers influence their students' perceptions of competence, autonomy, and relatedness. However, this model has rarely been tested in low socioeconomic elementary school students presenting academic and psychological difficulties. To fill this gap, this study examined whether student anxiety and academic achievement can moderate the association between teaching practices and student self-perceptions . A sample of 424 students and 45 teachers from five elementary schools located in low socioeconomic neighborhoods participated in the study over two consecutive years. Multilevel path analysis revealed that while most students felt competent and related to their teacher in highly structured and warm classrooms, anxious and low-achieving students benefited even more from teachers' structuring practices compared to their non-anxious or higher-achieving peers. Globally, our results partially support the application of the SSMMD for more vulnerable students.

BackgroundEngaging in sport has been suggested to be mitigate against psychological distress. Using a prospective-longitudinal design, we examine whether sport participation is associated with reduced psychological difficulties in adolescents and whether associations differ by sport and personal characteristics.Methods17 550 adolescents from grade 7 to 10 (mean age=14.4 years old) self-reported on sport participation, depressive symptoms, social anxiety symptoms and loneliness in Spring 2007 and 1 year later. Analyses tested the association between sport participation and subsequent psychological difficulties using linear regression, while adjusting for pre-existing psychological and sociodemographic characteristics. Analyses also verified whether associations differed by sport frequency (weekly/more than weekly) and type (team/individual) using Wald tests of parameter constraints, as well as sex, age and pre-existing psychological difficulties using interaction terms.ResultsAfter adjusting for potential confounders, sport participation predicted lower social anxiety symptoms (beta=−0.02 (−0.04, −0.01)) and loneliness (beta=−0.04 (−0.05, −0.02)), but not depressive symptoms. Moderation analyses showed that sport participation predicted greater reductions in depressive symptoms, social anxiety symptoms and loneliness in adolescents with higher baseline scores on each outcome. Associations did not differ by sport frequency and type, sex and age. Post hoc analyses revealed bidirectional associations between sport participation and social anxiety symptoms and loneliness.ConclusionsSport participation predicts small reductions in adolescent psychological distress. Reductions seem most important in youth experiencing greater pre-existing psychological difficulty. Our findings suggest that sport participation represents a protective factor that supports psychological resilience in at-risk youth.

Major depressive disorder (MDD) in young people is a leading cause of disability but most depressed youth are not treated, emphasizing the need for effective prevention. Our goal is to synthesize MDD onset prevention effects for the Blues Program, a brief cognitive-behavioral (CB) indicated prevention group, by merging data from four trials (three of which included CB bibliotherapy) and conducting an individual patient data (IPD) meta-analysis. Data were available from 766 high school/college students (M age = 16.4, SD = 2.3; 60% female, 64% White). CB group resulted in significantly lower MDD incidence rates relative to brochure control that persisted to 6-month follow-up; CB group also was associated with a lower 2-year MDD incidence rate relative to bibliotherapy but heterogeneity across trials was detected. Contrasts between bibliotherapy and brochure control were nonsignificant. For significant contrasts, the number needed to treat (NNT) by CB group to prevent one MDD onset relative to brochure or bibliotherapy ranged from 10 to 21. A brief CB group depression prevention intervention for at-risk adolescent is achieving meaningful effects compared to both active and minimal controls but outcomes need to be improved, perhaps by better screening or augmentations to produce more persistent intervention effects.

BackgroundEvidence regarding the association between adolescent internalising symptoms and school non-completion has been limited and inconclusive.AimsTo examine whether depressive and anxious symptoms at secondary school entry predict school non-completion beyond confounders and whether associations differ by baseline academic functioning.MethodWe used logistic regression to examine associations between depressive and anxious symptoms in grade 7 (age 12–14) and school non-completion (age 18–20) in 4962 adolescents.ResultsDepressive symptoms did not predict school non-completion after adjustment, but moderation analyses revealed an association in students with elevated academic functioning. A curvilinear association was found for anxiety: both low and high anxious symptoms predicted school non-completion, although only low anxiety remained predictive after adjustment.ConclusionsAssociations between internalising symptoms and school non-completion are modest. Common school-based interventions targeting internalising symptoms are unlikely to have a major impact on school non-completion, but may prevent non-completion in selected students.

The purpose of this study is to examine the prospective association between fluid reasoning skills in seventh grade and subsequent high school dropout in an at-risk population, independent of a number of important confounders. Participants are 4962 students from one of 56 high schools in the French Canadian province of Quebec. Three quarters of participants were intentionally representative of all schools in disadvantaged areas of the province. The Standard Progressive Matrices was administered to assess fluid reasoning, defined as the requisite skills for critical thought and complex problem resolution in novel situations, regardless of task and setting characteristics. Leaving high school from eighth grade onward, as a developmental milestone, was officially tracked and recorded by government sources. Dropout status was assigned if registration in school was discontinued without returning or obtaining a diploma within the period spanning from fall of Grade 8 to two years beyond expected graduation. Lower fluid reasoning skills significantly predicted less perseverance toward high school completion. Specifically, after adjusting for potential confounders, every standard deviation decrease in fluid reasoning predicted 21% increases in odds of dropout (OR = 1.21; 95% C1 = 1.06–1.37). Youth showing below average fluid reasoning skills at the secondary transition might benefit from teacher-student support and technologically-based interventions that bolster knowledge acquisition and learning-related skills. Early approaches to screening and preventive stimulation before student trajectories become clearly characterized by indiscriminate underachievement might circumvent high school dropout and are likely to be more cost-effective than letting the bio-psycho-social developmental risks associated with dropout take their course.

Refers to :Daniela Gonzalez-Sicilia, Frédéric N. Brière, Linda S. Pagani.Prospective associations between participation in leisure-time physical activity at age 6 and academic performance at age 12.Preventive Medicine, Volume 118, January 2019, Pages 135-141 (DOI: 10.1016/j.ypmed.2018.10.017); International audience

BackgroundPast research suggests that adolescents who witness violence are at risk of adjustment problems. However, few studies have implemented a longitudinal design and have accounted for direct experiences of victimisation and other major confounders. This prospective study examines the relationship between witnessing school violence and subsequent impairment and whether such associations depend on the kind of violence witnessed.Methods3936 adolescents from Quebec (Canada) were followed from ages 12 through 15 years. Linear regression tested associations between witnessing school violence at age 13 and subsequent antisocial behaviour (drug use, delinquency), emotional distress (social anxiety, depressive symptoms) and academic adjustment (school achievement, engagement) at age 15. We compared the relative contribution of differing forms of witnessing school violence versus being victimised directly.ResultsGeneral school violence predicted later impairment. The adjusted associations between indirectly experiencing violence as a bystander and subsequent impairment were comparable to those of direct victimisation. Witnessing covert and major violence was associated with drug use and delinquency. Witnessing minor violence was associated with increases in drug use, social anxiety, depressive symptoms and decreases in school engagement.ConclusionsAlmost all students witnessed school violence, which predicted impairment. Witnessing violence was associated with risk of subsequent adjustment problems 2 years later. Directly experienced victimisation showed a comparable magnitude of risk. This suggests that when it comes to symptoms of conduct disorder, witnessing violence might have the same impact as experiencing it directly. Witnessing earlier covert and major violence predicted social impairment whereas minor violence predicted psychological and academic impairment.

In this article, we the present the evaluation of the first phase of a KT initiative, the codification of the tacit and explicit knowledge of community social pediatrics (CSP) practitioners. As increasing numbers of professionals began working in the CSP field, it became necessary to capture the know-how to make it better understood. This first phase of the initiative took advantage of one of the KM stages, the codifying process that is absent from KT models. The evaluation aim to answer the question: “What is the CSPs practitioners level of familiarity with the codification document, as well as their perceptions of its utility and its contribution to the understanding of the CSP model”. The results, show that most respondents had consulted the codification document and were able to describe in detail parts of it. The results also show that they considered it to be a useful and necessary tool to guide practices and helpful in understanding the model. The results of this evaluation is paving the way for the next steps of the KT initiative.

For many children, leisure time represents a privileged moment to engage in physical activity. This study aims to examine prospective associations between kindergarten participation in leisure-time physical activity and academic performance by the end of sixth grade. Gender-specific associations are also explored. Participants are from the Quebec Longitudinal Study of Child Development, a 1997–1998 birth cohort from the province of Quebec, Canada (n = 2837). When children were age 6 (2004), mothers reported on their child's participation in three types of leisure-time physical activity (sports, other structured physical activities, and unstructured physical activities). At age 12 (2010), children's academic indicators were reported by teachers and by children themselves. Academic outcomes were then linearly regressed on leisure-time physical activity participation, while controlling for individual and family confounders. Unstructured physical activities were the most popular among both girls and boys. Sports were the second most popular activity among boys, whereas other structured physical activities were the second most popular among girls. Higher overall participation in leisure-time physical activity at age 6 was associated with better teacher-reported grades in language and math (β = 0.075 and β = 0.102, respectively) and self-reported grades in language (β = 0.103), as well as with higher classroom engagement (β = 0.077,) at age 12. Regression coefficients are standardized. All the associations were significant (p ≤ .05). Promoting leisure-time physical activity may be an effective way to encourage children to be active and to help them improve their academic performance, both leading to long-term wider benefits.

Background Adolescent depression prevention research has focused on mean intervention outcomes, but has not considered heterogeneity in symptom course. Here, we empirically identify subgroups with distinct trajectories of depressive symptom change among adolescents enrolled in two indicated depression prevention trials and examine how cognitive-behavioral (CB) interventions and baseline predictors relate to trajectory membership. Methods Six hundred thirty-one participants were assigned to one of three conditions: CB group intervention, CB bibliotherapy, and brochure control. We used group-based trajectory modeling to identify trajectories of depressive symptoms from pretest to 2-year follow-up. We examined associations between class membership and conditions using chi-square tests and baseline predictors using multinomial regressions. Results We identified four trajectories in the full sample. Qualitatively similar trajectories were found in each condition separately. Two trajectories of positive symptom course (low-declining, high-declining) had declining symptoms and were distinguished by baseline symptom severity. Two trajectories of negative course (high-persistent, resurging), respectively, showed no decline in symptoms or decline followed by symptom reappearance. Participants in the brochure control condition were significantly more likely to populate the high-persistent trajectory relative to either CB condition and were significantly less likely to populate the low-declining trajectory relative to CB group. Several baseline factors predicted trajectory classes, but gender was the most informative prognostic factor, with males having increased odds of membership in a high-persistent trajectory relative to other trajectories. Conclusions Findings suggest that CB preventive interventions do not alter the nature of trajectories, but reduce the risk that adolescents follow a trajectory of chronically elevated symptoms.

Purpose Increasing evidence suggests the existence of heterogeneity in the development of depressive symptoms during adolescence, but little remains known regarding the implications of this heterogeneity for the development of commonly co-occurring problems. In this study, we derived trajectories of depressive symptoms in adolescents and examined the codevelopment of multiple behavioral and academic problems in these trajectories. Methods Participants were 6,910 students from secondary schools primarily located in disadvantaged areas of Quebec (Canada) who were assessed annually from the age 12 to 16 years. Trajectories were identified using growth mixture modeling. The course of behavioral (delinquency, substance use) and academic adjustment (school liking, academic achievement) in trajectories was examined by deriving latent growth curves for each covariate conditional on trajectory membership. Results We identified five trajectories of stable-low (68.1%), increasing (12.1%), decreasing (8.7%), transient (8.7%), and stable-high (2.4%) depressive symptoms. Examination of conditional latent growth curves revealed that the course of behavioral and academic problems closely mirrored the course of depressive symptoms in each trajectory. Conclusions This pattern of results suggests that the course of depressive symptoms and other adjustment problems over time is likely to involve an important contribution of shared underlying developmental process(es).

BACKGROUND: Adolescent suicide attempts are disproportionally prevalent and frequently of low severity, raising questions regarding their long-term prognostic implications. In this study, we examined whether adolescent attempts were associated with impairments related to suicidality, psychopathology, and psychosocial functioning in adulthood (objective 1) and whether these impairments were better accounted for by concurrent adolescent confounders (objective 2). METHOD: Eight hundred and sixteen adolescents were assessed using interviews and questionnaires at four time points from adolescence to adulthood. We examined whether lifetime suicide attempts in adolescence (by T2, mean age 17) predicted adult outcomes (by T4, mean age 30) using linear and logistic regressions in unadjusted models (objective 1) and adjusting for sociodemographic background, adolescent psychopathology, and family risk factors (objective 2). RESULTS: In unadjusted analyses, adolescent suicide attempts predicted poorer adjustment on all outcomes, except those related to social role status. After adjustment, adolescent attempts remained predictive of axis I and II psychopathology (anxiety disorder, antisocial and borderline personality disorder symptoms), global and social adjustment, risky sex, and psychiatric treatment utilization. However, adolescent attempts no longer predicted most adult outcomes, notably suicide attempts and major depressive disorder. Secondary analyses indicated that associations did not differ by sex and attempt characteristics (intent, lethality, recurrence). CONCLUSIONS: Adolescent suicide attempters are at high risk of protracted and wide-ranging impairments, regardless of the characteristics of their attempt. Although attempts specifically predict (and possibly influence) several outcomes, results suggest that most impairments reflect the confounding contributions of other individual and family problems or vulnerabilites in adolescent attempters. Language: en

Background Questions remain regarding the consequences of illicit drug use on adolescent adjustment and the nature of mechanisms that may explain these consequences. In this study, we examined whether early-onset illicit drug use predicts subsequent academic and psychosocial adjustment and whether associations are socially-mediated by decreased school engagement and increased peer deviancy. Method 4885 adolescents were followed throughout secondary school. We used regressions to determine whether illicit drug use in grade 7 predicted academic achievement, school dropout, depressive symptoms, and conduct problems in grades 10–11, adjusting for potential confounders. We used path analysis to test whether significant associations were mediated by school engagement and peer deviancy in grade 8. Results Illicit drug use predicted conduct problems and school dropout, but not academic achievement and depressive symptoms. The association between illicit drug use and conduct problems was fully mediated by increased peer deviancy. The association between illicit drug use and school dropout was partially mediated by increased peer deviancy, but remained mostly direct. No indirect association via decreased school engagement was found. Examination of reverse pathways revealed that conduct problems and academic achievement in grade 7 predicted drug use in grades 10–11. These associations were mediated by peer deviancy and school engagement (conduct problems only). Conclusion Adolescent illicit drug use influences the risk of school dropout and conduct problems in part by contributing to deviant peer affiliation. Reciprocal social mediation characterizes the association between drug use and conduct problems. A reverse mechanism best explains the association with academic achievement.

Objective Our aim was to identify moderators of the effects of a cognitive behavioral group-based prevention program (CB group) and CB bibliotherapy, relative to an educational brochure control condition and to one another, in a school-based effectiveness randomized controlled prevention trial. Method 378 adolescents ( M age = 15.5, 68% female) with elevated depressive symptoms were randomized in one of three conditions and were assessed at pretest, posttest, and 6-month follow-up. We tested the moderating effect of three individual (baseline depressive symptoms, negative attributional style, substance use), three environmental (negative life events, parental support, peer support), and two sociodemographic (sex, age) characteristics. Results Baseline depressive symptoms interacted with condition and time. Decomposition indicated that elevated baseline depressive symptoms amplified the effect of CB bibliotherapy at posttest (but not 6-month follow-up) relative to the control condition, but did not modify the effect of CB group relative to the control condition or relative to bibliotherapy. Specifically, CB bibliotherapy resulted in lower posttest depressive symptoms than the control condition in individuals with elevated, but not average or low baseline symptoms. We found no interaction effect for other putative moderators. Conclusions Our findings suggest that bibliotherapy is effective only in participants who have elevated depressive symptoms at baseline. The fact that no study variable moderated the effects of CB group, which had a significant main effect in reducing depressive symptoms relative to the control condition, suggests that this indicated prevention intervention is effective for a wide range of adolescents.

Objectif: Identifier des prédicteurs distaux et proximaux de l'initiation de la consommation d'ecstasy à l'adolescence. Méthode: L'échantillon comprenait 2162 adolescents issus d'écoles secondaires de milieux défavorisés du Québec, suivis annuellement pendant 5 ans. L'analyse causale a été utilisée pour prédire l'initiation de la consommation d'ecstasy en secondaire 5 (16–17 ans) à partir de prédicteurs en secondaire 1 et 2 (12–14 ans) et en secondaire 4 (15–16 ans). Résultats: Les adolescents qui initiaient la consommation d'ecstasy en secondaire 5 présentaient un risque accru sur de multiples facteurs, comparativement aux non-consommateurs. L'initiation était principalement prédite par des facteurs de risque proximaux liés à la consommation individuelle ainsi qu'à la consommation et à la déviance des pairs. Néanmoins, plusieurs facteurs proximaux se développaient en continuité avec leur facteur distal correspondant (lien indirect). La consommation de marijuana était le prédicteur le plus puissant de l'initiation de la consommation d'ecstasy, le risque relatif étant, toutes choses égales par ailleurs, 2,04 fois plus élevé chez les adolescents ayant consommé de la marijuana l'année précédente (secondaire 4). Conclusions: L'initiation de la consommation d'ecstasy en secondaire 5 semble globalement liée à un profl extériorisé plutôt qu'intériorisé. Cette consommation était fortement associée à la consommation d'autres substances et partage probablement plusieurs facteurs de risque avec la consommation de ces autres substances, en particulier la consommation de marijuana.

Childhood disruptiveness is one of the most important antecedents of heavy substance use in adolescence, especially among boys. The first aim of the present study is to verify whether parental monitoring and friend conventionality protect disruptive boys from engaging in heavy substance-use in adolescence. The second purpose is to examine whether these protective effects are strengthened by attachment to parents or friends respectively. Finally, the third objective is to verify whether the expected protective effect of parental monitoring could be mediated through exposure to conventional friends. A sample of 1037 boys from low socioeconomic neighbourhoods was followed from childhood (age 6) to adolescence (age 15). Parent, teacher, and self-reported measures were used to measure disruptiveness, parental monitoring, family attachment, friend conventionality, and attachment to friends. Results suggest that parental monitoring and friends' conventionality mitigated the relationship between childhood disruptiveness and adolescence heavy substance use. Exposure to conventional friends further mediated the protective effect of parent monitoring. The postulated enhancement of attachment quality on the protective effect of parents or peer behaviors was not confirmed, but low attachment was related to heavier substance use in highly monitored disruptive boys. Parental monitoring, family attachment, and peer conventionality are factors amenable to intervention, and thus represent promising targets for future prevention strategies aimed at-risk boys. Our results underscore the importance of simultaneously addressing the behavioral and the affective dimensions in interventions with parents.

This article presents the results from the evaluation of the Montreal Brief and Intensive Intervention (BII) program designed to prevent emergency placements or other longer-term services by Youth centers in situations involving family crises by providing short-term, intensive interventions. A multimethods evaluation design was used to evaluate program implementation, processes and outcomes. Quantitative implementation evaluation results showed that the program was globally well implemented, except for two of its core principles: intervention briefness and concrete support. Qualitative process evaluation results were helpful in explaining why these principles were poorly implemented and underscored, in particular, the importance of BII staff members' understanding and attitudes. The implementation results were linked to the outcome evaluation results in order to identify the predictors (characteristics of families and intervention) of success of the intervention. Practical implications are discussed.

Adolescent suicide attempts are disproportionally prevalent and frequently of low severity, raising questions regarding their long-term prognostic implications. In this study, we examined whether adolescent attempts were associated with impairments related to suicidality, psychopathology, and psychosocial functioning in adulthood (objective 1) and whether these impairments were better accounted for by concurrent adolescent confounders (objective 2).Eight hundred and sixteen adolescents were assessed using interviews and questionnaires at four time points from adolescence to adulthood. We examined whether lifetime suicide attempts in adolescence (by T2, mean age 17) predicted adult outcomes (by T4, mean age 30) using linear and logistic regressions in unadjusted models (objective 1) and adjusting for sociodemographic background, adolescent psychopathology, and family risk factors (objective 2).In unadjusted analyses, adolescent suicide attempts predicted poorer adjustment on all outcomes, except those related to social role status. After adjustment, adolescent attempts remained predictive of axis I and II psychopathology (anxiety disorder, antisocial and borderline personality disorder symptoms), global and social adjustment, risky sex, and psychiatric treatment utilization. However, adolescent attempts no longer predicted most adult outcomes, notably suicide attempts and major depressive disorder. Secondary analyses indicated that associations did not differ by sex and attempt characteristics (intent, lethality, recurrence).Adolescent suicide attempters are at high risk of protracted and wide-ranging impairments, regardless of the characteristics of their attempt. Although attempts specifically predict (and possibly influence) several outcomes, results suggest that most impairments reflect the confounding contributions of other individual and family problems or vulnerabilites in adolescent attempters.

Cannabis use is highly prevalent in late adolescence, but not all users experience significant negative consequences. Little information is available to identify the substance use patterns and risk factors of users who are at greater risk of experiencing negative consequences. In this prospective study, we aimed to empirically identify latent classes of substance use in adolescent cannabis users and to examine how these classes relate to antecedent psychosocial predictors and subsequent substance-related outcomes. The sample was recruited from 68 high schools in Quebec and consisted of 1618 participants who reported using cannabis in grade 10. We used latent class analysis (LCA) to empirically identify classes of users based on the age of onset, frequency, and typical quantity of cannabis and other substance use, as well as substance mixing behaviors. We then compared classes in terms of a) socio-demographic and psychosocial predictors in grades 7-8 and b) substance-related consequences in grade 11. Four distinct classes were identified: Late-Light Users (28%); Late-Heavy+Polydrug Users (14%); Early-Moderate Users (33%); Early-Heavy+Polydrug Users (26%). Late-Light Users reported the lowest levels of substance use, while Early-Heavy+Polydrug Users reported the highest levels of substance. Intermediate levels of susbstance use were found in the other two classes. Sex, age, delinquency, peer delinquency, school bonding, parental monitoring, and parental conflict all helped differentiate classes. Class membership predicted substance-related harm, with greater consequences in early- and late-onset heavy using classes. In light of results, in addition to age and sex, screening and intervention for risky cannabis use among adolescents should focus on school bonding in order to target the most risky late-onset adolescents, and on peer delinquency in order to target the most risky early-onset ones.

Objective: We tested whether a brief cognitive behavioral (CB) group and bibliotherapy prevention reduce major depressive disorder (MDD) onset, depressive symptoms, and secondary outcomes relative to brochure controls in adolescents with self-reported depressive symptoms when school personnel recruit participants and deliver the intervention. Method: Three hundred seventy-eight adolescents (M age 15.5 years, SD 1.2; 68% female, 72% White) with elevated self-assessed depressive symptoms were randomized to a 6-session CB group, minimal contact CB bibliotherapy, or educational brochure control. Participants were assessed at pretest, posttest, and 6-month follow-up. Results: CB group participants showed a significantly lower risk for major depressive disorder onset (0.8%), compared to both CB bibliotherapy (6.3%) and brochure control (6.5%; hazard ratio 8.1 and 8.3, respectively). Planned contrasts indicated that CB group resulted in lower depressive symptom severity than brochure control at posttest (p .03, d 0.29) but not 6-month follow-up; differences between CB group and bibliotherapy were nonsignificant at posttest and 6-month follow-up. Condition effects were nonsignificant for social adjustment and substance use. Conclusions: The finding that a brief CB group intervention delivered by real-world providers significantly reduced MDD onset relative to both brochure control and bibliotherapy is very encouraging, although effects on continuous outcome measures were small or nonsignificant and approximately half the magnitude of those found in efficacy research, potentially because the present sample reported lower initial depression.

Background Limited information exists regarding the long-term development of comorbidity between Major Depressive Disorder (MDD) and Alcohol Use Disorder (AUD; abuse/dependence). Using a representative prospective study, we examine multiple aspects pertaining to MDD + AUD comorbidity, with a focus on the relation between disorders across periods (adolescence, early adulthood, adulthood) and cumulative impairments by age 30. Method 816 participants were diagnostically interviewed at ages 16, 17, 24, and 30. Results Rates of comorbid MDD + AUD were low in adolescence (2%), but increased in early adulthood (11%) and adulthood (7%). Rates of cumulative comorbidity were elevated (21%). Most individuals with a history of MDD or AUD had the other disorder, except for women with MDD. Prospectively, adolescent AUD predicted early adult MDD, while early adult MDD predicted adult AUD. Compared to pure disorders, MDD + AUD was associated with higher risk of alcohol dependence, suicide attempt, lower global functioning, and life dissatisfaction. Conclusions Lifetime rates of comorbid MDD + AUD were considerably higher than in cross-sectional studies. Comorbidity was partly explained by bidirectional and developmentally-specific associations and predicted selected rather than generalized impairments. Clinically, our findings emphasize the need to always carefully assess comorbidity in patients with MDD or AUD, taking into account concurrency and developmental timing.

OBJECTIVE: It remains unclear whether school environments can influence the emotional health of adolescents. In this large-scale prospective study, we use multilevel modeling to examine whether the school socioeducational environment contributes to the risk of developing depressive symptoms in secondary school students. METHODS: As part of a longitudinal study on school success in disadvantaged communities, 5262 adolescents from 71 secondary schools were followed annually. Socioeducational environment was assessed by a composite measure of social climate, learning opportunities, fairness and clarity of rules, and safety. Depressive symptoms were evaluated by using the Center for Epidemiologic Studies Depression scale. Multilevel regressions tested the association between school socioeducational environment in grade 8 and depressive symptoms in grades 10 to 11, adjusting for previous depressive symptoms in grade 7 and potential confounders at the individual and school levels. RESULTS: Modest but significant variation in depressive symptoms was found between schools (intraclass correlation = 3.3%). School-level socioeducational environment in grade 8 was predictive of student depressive symptoms in grades 10 to 11, even after adjusting for potential school and individual confounders. This association was slightly stronger for girls. Student perceptions of school socioeducational environment were also predictive of depressive symptoms. Other school-level factors, including school size, were not predictive of depressive symptoms once socioeducational environment was taken into account. CONCLUSIONS: Adolescents who attend a secondary school with a better socioeducational environment are at reduced risk of developing depressive symptoms. School environments appear to have a greater influence on risk in adolescent girls than boys.

Background Research has raised significant concern regarding the affective consequences of synthetic drug use. However, little evidence from well-controlled longitudinal studies exists on these consequences. The aim of this study was to determine whether use of meth/amphetamine (speed) and ±3,4-methylenedioxymethamphetamine (MDMA, ecstasy) is independently predictive of subsequent depressive symptoms in adolescents. Methods A sample of 3880 adolescents from secondary schools in disadvantaged areas of Quebec, Canada, were followed over time (2003–2008). Logistic regression was used to test the association between meth/amphetamine and MDMA use in grade 10 (ages 15–16 years) and elevated depressive symptoms on an abridged Center for Epidemiologic Studies-Depression scale in grade 11, controlling for pre-existing individual and contextual characteristics. Results After adjustment, both MDMA use (OR 1.7, 95% CI 1.1 to 2.6) and meth/amphetamine use (OR 1.6, 95% CI 1.1 to 2.3) in grade 10 significantly increased the odds of elevated depressive symptoms in grade 11. These relationships did not vary by gender or pre-existing depressive symptoms. Increased risk was particularly observed in concurrent usage (OR 1.9, 95% CI 1.2 to 2.9). Conclusions Adolescent use of meth/amphetamine and MDMA (particularly concurrent use) is independently associated with subsequent depressive symptoms. Further enquiry must determine whether these associations reflect drug-induced neurotoxicity and whether adolescence is a period of increased vulnerability to the hazards of synthetic drug exposure.

Background/Aims The simultaneous use of alcohol and cannabis is common among adolescents, but has been little studied. In this study, we examine predictors and consequences of this behavior in a population-based sample of high school students. Method Self-reports were obtained from students in Quebec (Canada) followed throughout high school (N = 6589). Logistic regressions were used to test the association between individual, family, and peer-related predictors in grades 7–8 and simultaneous alcohol and cannabis use in grade 10, as well as between simultaneous alcohol and cannabis use in grade 10 and experiencing 3 or more substance-related problems of various types (legal, physical, etc.) in grade 11. Results Most predictors in grades 7–8 were associated with simultaneous alcohol and cannabis use in grade 10. Only variables reflecting early-onset substance use involvement — alcohol intoxication, cannabis use, and drug use by close friend(s) — remained predictive in a multivariate model. Simultaneous alcohol and cannabis use was associated with increased substance-related problems in grade 11, above and beyond baseline problems and the concurrent use of the two substances in separate episodes in grade 10. Conclusions Simultaneous alcohol and cannabis use 1) is anticipated by multiple psychosocial risk factors which come together with individual and peer substance use in early high school and 2) is independently predictive of subsequent substance-related problems. Providing adolescents with adequate information regarding the potential harm of simultaneous use may be a useful prevention strategy.

To identify distal and proximal predictors of ecstasy use initiation during adolescence.The sample included 2162 adolescents from Québec disadvantaged community high schools, with an annual follow-up for 5 years. Path analysis was used to predict ecstasy use initiation in secondary 5 (aged 16 to 17 years) from predictors in secondary 1 and 2 (aged 12 to 14 years) and in secondary 4 (aged 15 to 16 years).Secondary 5 adolescents initiating ecstasy use showed a higher risk on multiple factors, compared with nonusers. Initiation was mainly predicted by proximal risk factors related to individual use as well as peer use and deviance. Nevertheless, many proximal factors developed consistently with their corresponding distal factor (indirect link). Marijuana use was the strongest predictor of ecstasy use initiation. All things being equal, relative risk was 2.04 times higher in adolescents having used marijuana in the past year (secondary 4).Ecstasy use initiation in secondary 5 seems to be globally related to an externalized, rather than internalized, profile. This ecstasy use was strongly associated with other substance use and likely shares many risk factors with other substance use, specifically marijuana use.

The goal of this study was to determine whether adolescents’ relative popularity plays a protective role against peer influences towards substance abuse as suggested by a Social Discrepancy model (Bukowski et al., 2008), or whether, conversely, adolescents’ relative popularity represents a vulnerability factor as suggested by the Socialization-Popularity model (Allen et al., 2005). To achieve this goal, we used a sample of 531 adolescents followed from ages 10-11 through ages 14-15. Participants and their friends provided self-reports of their substance use. Peers rated participants and their friends in terms of popularity. Results suggest that having friends that consume more at ages 12-13 predicts an increase in substance use from ages 10-11 to ages 14-15. In line with the Socialization-Popularity model, but opposite to the Social Discrepancy model, adolescents who were more popular were at greater risk of adopting the drug- related behaviors of their friends, particularly if these friends were also popular. Theoretical and practical implications of these results are discussed.

Objective: Adolescent depressive symptoms are associated with difficult family relationships. Family systems and interpersonal theories of depression suggest that this association could reflect a circular process in which symptoms and family functioning affect each other over time. Few longitudinal studies have tested this hypothesis, and the results of these studies have been equivocal. In this study, we examine reciprocal prospective associations in early adolescence between depressive symptoms and 2 important aspects of parent–child relationships: communication and conflict. Methods: Participants were 3862 students who annually filled out self-reports. Path analysis was used to examine prospective associations between depressive symptoms and perceived communication and conflict with parents from the age of 12 to 13 and 14 to 15 years. Independence of these associations was assessed by controlling for family context (parental separation and family socioeconomic status) and adolescent behaviour problems (delinquent behaviours and substance use). Sex differences were evaluated with multiple group analysis. Results: Reciprocal prospective associations were found between depressive symptoms and perceived conflict with parents, but not between depressive symptoms and communication with parents. Depressive symptoms were found to predict poorer communication with parents over time, but communication was not predictive of lower depressive symptoms in subsequent years. All paths were sex-invariant and independent from family context and behaviour problems. Conclusion: This study highlights the importance of considering the potential impact of adolescent symptomatology on parent–child relationships and suggests that reciprocity may characterize the association between depressive symptoms and negative aspects of parent–child relationships. The role of adolescent perceptions in the interplay between depressive symptoms and family relationships remains to be clarified., Objectif : Les symptômes dépressifs des adolescents sont associés à des relations familiales difficiles. Les systèmes familiaux et les théories interpersonnelles de la dépression suggèrent que cette association pourrait refléter un processus circulaire dans lequel les symptômes et le fonctionnement familial exercent une influence les uns sur les autres avec le temps. Peu d’études longitudinales ont vérifié cette hypothèse, et elles ont conclu à des résultats équivoques. Dans cette étude, nous examinons les associations prospectives réciproques du début de l’adolescence entre les symptômes dépressifs et 2 aspects importants des relations parent–enfant : la communication et le conflit. Méthodes : Les participants étaient 3862 élèves qui remplissaient chaque année une autoévaluation. L’analyse des pistes causales a servi à examiner les associations prospectives entre les symptômes dépressifs et la communication et le conflit perçus avec les parents, de 12 à 13 ans et de 14 à 15 ans. L’indépendance de ces associations a été évaluée en contrôlant le contexte familial (séparation parentale et statut socioéconomique familial) et les problèmes de comportement de l’adolescent (comportements délinquants et utilisation de substances). Les différences selon le sexe ont été évaluées par une analyse de groupes multiples. Résultats : Des associations prospectives réciproques ont été observées entre les symptômes dépressifs et le conflit perçu avec les parents, mais non entre les symptômes dépressifs et la communication avec les parents. Les symptômes dépressifs prédisaient une communication médiocre avec les parents avec le temps, mais la communication ne prédisait pas de symptômes dépressifs plus faibles dans les années subséquentes. Toutes les pistes ne variaient pas selon le sexe et étaient indépendantes du contexte familial et des problèmes de comportement. Conclusion : Cette étude souligne l’importance de tenir compte de l’effet potentiel de la symptomatologie adolescente sur les relations parent–enfant, et suggère que la réciprocité peut caractériser l’association entre les symptômes dépressifs et les aspects négatifs des relations parent–enfant. Le rôle des perceptions des adolescents dans l’interaction entre les symptômes dépressifs et les relations familiales demeure à préciser.