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BACKGROUND: Although the link between alcohol involvement and behavioral phenotypes (e.g. impulsivity, negative affect, executive function [EF]) is well-established, the directionality of these associations, specificity to stages of alcohol involvement, and extent of shared genetic liability remain unclear. We estimate longitudinal associations between transitions among alcohol milestones, behavioral phenotypes, and indices of genetic risk. METHODS: Data came from the Collaborative Study on the Genetics of Alcoholism (n = 3681; ages 11-36). Alcohol transitions (first: drink, intoxication, alcohol use disorder [AUD] symptom, AUD diagnosis), internalizing, and externalizing phenotypes came from the Semi-Structured Assessment for the Genetics of Alcoholism. EF was measured with the Tower of London and Visual Span Tasks. Polygenic scores (PGS) were computed for alcohol-related and behavioral phenotypes. Cox models estimated associations among PGS, behavior, and alcohol milestones. RESULTS: Externalizing phenotypes (e.g. conduct disorder symptoms) were associated with future initiation and drinking problems (hazard ratio (HR)⩾1.16). Internalizing (e.g. social anxiety) was associated with hazards for progression from first drink to severe AUD (HR⩾1.55). Initiation and AUD were associated with increased hazards for later depressive symptoms and suicidal ideation (HR⩾1.38), and initiation was associated with increased hazards for future conduct symptoms (HR = 1.60). EF was not associated with alcohol transitions. Drinks per week PGS was linked with increased hazards for alcohol transitions (HR⩾1.06). Problematic alcohol use PGS increased hazards for suicidal ideation (HR = 1.20). CONCLUSIONS: Behavioral markers of addiction vulnerability precede and follow alcohol transitions, highlighting dynamic, bidirectional relationships between behavior and emerging addiction.

BACKGROUND: Green space exposures may promote child mental health and well-being across multiple domains and stages of development. The aim of this study was to investigate associations between residential green space exposures and child mental and behavioral health at age 4-6 years. METHODS: Childrens internalizing and externalizing behaviors in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) cohort in Shelby County, Tennessee, were parent-reported on the Child Behavior Checklist (CBCL). We examined three exposures-residential surrounding greenness calculated as the Normalized Difference Vegetation Index (NDVI), tree cover, and park proximity-averaged across the residential history for the year prior to outcome assessment. Linear regression models were adjusted for individual, household, and neighborhood-level confounders across multiple domains. Effect modification by neighborhood socioeconomic conditions was explored using multiplicative interaction terms. RESULTS: Children were on average 4.2 years (range 3.8-6.0) at outcome assessment. Among CANDLE mothers, 65% self-identified as Black, 29% as White, and 6% as another or multiple races; 41% had at least a college degree. Higher residential surrounding greenness was associated with lower internalizing behavior scores (-0.66 per 0.1 unit higher NDVI; 95% CI: -1.26, -0.07) in fully-adjusted models. The association between tree cover and internalizing behavior was in the hypothesized direction but confidence intervals included the null (-0.29 per 10% higher tree cover; 95% CI: -0.62, 0.04). No associations were observed between park proximity and internalizing behavior. We did not find any associations with externalizing behaviors or the attention problems subscale. Estimates were larger in neighborhoods with lower socioeconomic opportunity, but interaction terms were not statistically significant. CONCLUSIONS: Our findings add to the accumulating evidence of the importance of residential green space for the prevention of internalizing problems among young children. This research suggests the prioritization of urban green spaces as a resource for child mental health.

Background: While accumulating research has tested the hypothesis that screen time causes psychiatric symptoms in children, less attention has been paid to the hypothesis that children with psychiatric symptoms change their patterns of screen time and digital media use. We aimed to test whether children with psychiatric symptoms subsequently change their patterns of screen time and digital media use. Methods: N = 9,066 children primarily aged 9–10 in the Adolescent Brain Cognitive Development Study at baseline and 1-year later. Psychiatric symptoms included internalizing, attention, and externalizing symptoms. Screen time was measured as ordinally defined weekday and weekend time on social and nonsocial [e.g., YouTube] digital media). Models assessed psychiatric symptoms as predictors of screen time, and screen time as predictors of psychiatric symptoms, controlled for baseline measures of each, sex, age, race/ethnicity, and income. Results: Children with psychiatric symptoms spent more time on non-social media one year later compared with peers. Considering total psychiatric problems, clinical levels of problems predicted higher levels of weekday (OR = 1.22, 95% CI 1.22–1.23) and weekend (OR = 1.10, 95% CI 1.09–1.11) nonsocial screen time. For nearly all analyses of psychiatric symptoms predicting screen time, associations were highest for a non-social screen time outcome rather than a social screen time outcome (Highest OR = 1.65, 95% CI 1.63–1.67, clinical rule breaking predicting weekday nonsocial screen time). Comparable magnitude associations were observed for social and nonsocial media use predicting future psychiatric symptoms, suggesting bidirectionality. Conclusion: Children with psychiatric symptoms have different subsequent media use patterns, including higher rates of subsequent nonsocial engagement. Ensuring that ongoing data collection and analysis efforts attend to temporality and transitions in the relation between media use and psychiatric symptoms will accelerate progress in the field. [ABSTRACT FROM AUTHOR]

Introduction: Children and adolescents treated in specialty mental health services are more likely to have sleep disturbances than those without mental health problems. Few studies have investigated the relationship between sleep and psychopathology in broad clinical samples of children. We examined the relationship between sleep disturbance and age on internalizing and externalizing psychopathology in a sample who sought treatment at children's mental health centers. Methods: Secondary data analyses were completed on a sample of children (N = 13,472; aged 4 to 18; 55% male) from 39 children's mental health agencies in Ontario, Canada, who completed a semi-structured assessment, the interRAI Children and Youth Mental Health (ChYMH). A split-half sample approach was utilized (S1 n = 6,773, S2 n = 6,699). Hierarchical regressions examined the effects of sleep disturbances (i.e., difficulty falling asleep, staying asleep, night waking, bedtime resistance, falling asleep during the day) on internalizing and externalizing symptoms, above and beyond established child- (i.e., age, sex, sensory sensitivity, pain) and family-level variables (family functioning, caregiver distress, parenting strengths). Age was tested as a moderator for sleep disturbances on both outcome variables. Results: Overall, 6.7% of children had clinically significant sleep disturbance scores (≥10 out of 16) on the interRAI ChYMH. In both samples, sleep disturbances predicted internalizing (S1 ΔR2 = 10%, S2 ΔR2 = 10%) and externalizing symptoms (S1 ΔR2 = 2%, S2 ΔR2 = 1%), above and beyond child and family variables. Age moderated the relationship between sleep disturbances and internalizing symptoms (S1 ß = 0.07; S2 ß = 0.07; ΔR2 = 0.004 in both samples), but not externalizing symptoms; sleep disturbance was more strongly related to internalizing symptoms amongst adolescents (ß = 0.98) than children (ß = 0.62). Discussion: The relationship between sleep and internalizing symptoms appears to change as children move through development. Further, sleep was a stronger predictor of internalizing problems in adolescents than children, suggesting an additional focus of clinician efforts in this age group. These findings strengthen the importance of routine assessment of sleep, as is done with the interRAI ChYMH. [ABSTRACT FROM AUTHOR]

Risky sexual behavior (RSB) has been linked to externalizing problems, substance use, and, in a recent study by our lab, internalizing problems. The current study builds upon previous work investigating the relationship between RSB and internalizing problems (INT) by controlling for externalizing problems (EXT) to account for the correlation between INT and EXT. We used a twin sample from Colorado (N = 2,544) to investigate phenotypic and genetic relationships between the three latent constructs, as well as potential sex differences in those relationships. We hypothesized that the relationship between RSB and INT would be stronger for females than for males, whereas the relationship between RSB and EXT would be stronger for males than for females. We used phenotypic confirmatory factor analysis and multivariate twin analyses to address research questions. Our results show significant phenotypic relationships among RSB, INT, and EXT and provide modest evidence in males for a significant association between RSB and INT that persists when controlling for EXT, a finding which we interpret with caution. Our sex differences hypothesis was not fully supported, although the direction of effects was in the direction hypothesized for the association between RSB and INT. We discuss the complexity of RSB as a phenotype and the potential implications for public health. [ABSTRACT FROM AUTHOR]

Traditional mental health diagnoses rely on symptom-based classifications. Yet this approach can oversimplify clinical presentations as diagnoses often do not adequately map onto neurobiological features. Alternatively, our study used structural imaging data and a semisupervised machine learning technique, heterogeneity through discriminative analysis, to identify neurobiological subtypes in 9- to 10-year-olds with high psychopathology endorsements (n = 9,027). Our model revealed two stable neurobiological subtypes (adjusted Rand index = 0.38). Subtype 1 showed smaller structural properties, elevated conduct problems and attention-deficit/hyperactivity disorder symptoms, and impaired cognitive performance compared to Subtype 2 and typically developing youth. Subtype 2 had larger structural properties, cognitive abilities comparable to typically developing youth, and elevated internalizing symptoms relative to Subtype 1 and typically developing youth. These subtypes remained stable in their neurobiological characteristics, cognitive ability, and associated psychopathology traits over time. Taken together, our data-driven approach uncovered evidence of neural heterogeneity as demonstrated by structural patterns that map onto divergent profiles of psychopathology symptoms and cognitive performance in youth. General Scientific Summary: This study identified neurobiological subtypes underlying high levels of general psychopathology. Smaller/thinner brains were associated with specific externalizing symptoms and cognitive deficits. Larger/thicker brains were associated with elevated internalizing symptoms and intact cognition. Neural characteristics, cognition, and psychopathology among the subtypes remained largely stable across a 2-year period. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is a global public health problem and is highly prevalent among justice-involved populations. Pediatric TBI is linked with long-term negative outcomes and is correlated with substance use, criminal behavior, psychiatric disorders, and disruptions in neurocognition. These same TBI correlates are evident among youth with psychopathic traits. Given ongoing neurobiological and social development in adolescence, understanding the link between psychopathic traits and TBI in justice-involved youth is critical. A sample of 263 male adolescents were recruited from a maximum-security juvenile justice facility. Using a structural equation modeling (SEM) framework, measurement invariance of psychopathic traits (TBI ±) was tested, and psychopathy scores were accounted for in terms of TBI variables (severity, age of first TBI, total number), participant's age, IQ, substance use, and internalizing psychopathology. There was evidence of strong invariance across TBI status and those with TBI had higher affective and impulsive lifestyle psychopathic traits than adolescents without TBI. The SEM indicated that TBI severity was associated with lower IQ scores, which in turn were associated with increased lifestyle/antisocial (Factor 2) psychopathic traits. Total number of TBIs was associated with higher substance use, which was associated with both increased interpersonal/affective (Factor 1) and Factor 2 psychopathic traits. These TBI variables also had indirect associations with psychopathic traits through IQ and substance use. The findings indicate that TBI is associated with psychopathic traits and suggest that disturbances in cognition and substance use may be treatment targets for youth with TBI and psychopathic traits. [ABSTRACT FROM AUTHOR]

Introduction: Along with pubertal development, the transition to adolescence brings about increased risk for sleep disturbances and mental health problems. Functional connectivity of overlapping large-scale brain networks, such as increased connectivity between the default mode and dorsal attention networks, has been reported to relate to both sleep and mental health problems. Clarifying whether pubertal development interacts with sleep disturbances and functional brain networks to predict mental health may provide information to improve the timing and design of interventions targeting sleep disturbances in adolescents. Methods: To examine how pubertal status and tempo relate to sleep disturbances and shape the relationship between sleep disturbances and mental health problems, we harnessed a large sample of children aged 10-14 years from the Adolescent Brain and Cognitive Development (ABCD) Study (N ~ 3,000-10,000). We used graph theoretical tools to probe how pubertal development concurrently interacts with sleep disturbances and brain network organization to predict mental health problems. Results: We found that advanced pubertal status, but not pubertal tempo, predicted sleep disturbances; however, both pubertal status and tempo interact with sleep disturbances to predict mental health problems and engage in three-way interactions with sleep and brain network organization to predict mental health problems. Discussion: Overall, this work suggests that less advanced pubertal status and slower tempo are risk factors for the strongest links between sleep disturbances, brain organization, and mental health problems. Further, our findings speak to the importance of accounting for interactions in the constellation of factors that surround complex behavioral and clinical syndromes, here internalizing and externalizing disorders, and provide new context to consider for targeted interventions. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) have a profound impact on individuals, shaping their long-term health and life opportunities. This study delves into the complex ties between ACEs and the socioemotional development of Australian children and youth by examining the relationships between adverse childhood experiences and externalizing, internalizing, and prosocial behaviors. This study utilized data from the Longitudinal Study of Australian Children and employed the generalized estimating equation method to investigate the relationships between adverse childhood experiences and externalizing, internalizing, and prosocial behaviors in Australian children and adolescents. Adverse childhood experiences such as physical punishment, hostile parenting, parental conflicts, separation, financial strain, and parental mental health issues increased the risk of externalizing and internalizing behaviors while reducing prosocial behaviors. The risk increases with the number of ACEs, as evidenced by the incidence ratio (IR); for example, for externalizing behaviors, an ACEs score of one leads to IR = 1.69, while an ACEs score of 4 results in IR = 3.34. Similar trends were observed for internalizing and prosocial behaviors. The presence of imbalanced longitudinal data, arising from variations in the number of observations across different time points, challenges robust inferences. Furthermore, this study investigates the relationship between ACEs and behavioral problems, without establishing causality. Consequently, the results should be interpreted with caution. The findings of this study highlight that adverse childhood experiences significantly influence behavioral outcomes in children and adolescents. These findings underscore the critical need for early detection and intervention to mitigate the consequences of traumatic childhood experiences. • Adverse childhood experiences (ACEs) significantly impact the socioemotional development of children and adolescents. • Higher ACEs scores correspond to an elevated risk of externalizing, and internalizing, while diminishing prosocial behaviors. • Early detection and intervention are needed to reduce the detrimental effects of ACEs on children's behavior. [ABSTRACT FROM AUTHOR]

Dimensional frameworks of psychopathology call for multivariate approaches to map co-occurring disorders to index what symptoms emerge when and for whom. Ecological momentary assessment (EMA) offers a method for assessing and differentiating the dynamics of co-occurring symptoms with greater temporal granularity and naturalistic context. The present study used multivariate mixed effects location-scale modeling to characterize the time-varying dynamics of depressed mood and anxiety for women diagnosed with social anxiety disorder (SAD) and major depression (MDD). Women completed five daily EMA surveys over 30 days (150 EMA surveys/woman, T ≈ 5250 total observations) and two clinical diagnostic and retrospective self-report measures administered approximately two months apart. There was evidence of same-symptom lagged effects (bs = 0.08–0.09), but not cross-symptom lagged effects (b s < 0.01) during EMA. Symptoms co-varied such that momentary spikes from one's typical level of anxiety were associated with increases in momentary depressed mood (b = 0.19) and greater variability of depressed mood (b = 0.06). Similarly, spikes from one's typical levels of depressed mood were associated with increases in momentary anxiety (b = 0.19). Furthermore, the presence and magnitude of effects demonstrated person-specific heterogeneity. Our findings are constrained to the dynamics of depressed and anxious mood among cisgender women with primary SAD and current or past MDD. Findings from this work help to characterize how daily experiences of co-occurring mood and anxiety fluctuate and offer insight to aid the development of momentary, person-specific interventions designed to regulate symptom fluctuations. • The nature of covariation in mood and anxiety varies from person to person. • Multivariate mixed effects location-scale modeling was used. • Momentary spikes in one symptom were associated with increases in the other. • The presence and magnitude of effects demonstrated person-specific heterogeneity. • Findings inform the design of momentary, person-specific interventions. [ABSTRACT FROM AUTHOR]

Abstract This study examined the relation between pandemic-related stressors and mental health among young people (YP) in India during two time points in the waning phase of the pandemic. We use data from two cross-sectional waves of over 20,000 YP aged 5–19 in February 2022, during the peak of the Omicron wave, and October 2022, during a reduction in infections and easing of restrictions. COVID illness/death in the family’s social network, current lockdown stringency, and significant change in household income were examined in relation to adult respondents’ reports of YP internalizing symptoms. Internalizing symptoms declined slightly from February to October 2022. COVID-19 illness/death in the family’s network was generally associated with more internalizing symptoms. Higher lockdown stringency was associated with lower levels of internalizing symptoms. YP in households with increases in income tended to have more internalizing symptoms. Many associations were driven by older adolescents and were stronger during the earlier (Feb-2022) than later (Oct-2022) data collection time-points. The findings illustrate the importance of anchoring results within a study’s specific geographic context, including concurrent events during the study period. Importantly, findings that may initially seem counterintuitive ultimately illuminate the dynamic and complex processes underlying child and adolescent mental health.

This study aims to describe maternal depressive symptoms (MDS) trajectories in a longitudinal study extending from pregnancy to 27 years after the birth of the firstborn child. We also explored the associations of both MDS trajectories and child internalizing and externalizing problem trajectories with maternal adjustment (adaptive functioning, emotional and behavioral problems). The population-based study was conducted in Tampere, Finland, and the sample comprised 356 first-time mothers. MDS were screened with the Edinburgh Postnatal Depression Scale during pregnancy, first week after delivery, 2 and 6 months postnatally, and when the child was 4–5, 8–9, 16–17, and 26–27 years of age. The internalizing and externalizing problems of the children were assessed with the Child Behavior Checklist when the child was 4–5, 8–9, and 16–17 years of age. Maternal adaptive functioning and internalizing and externalizing problems were assessed with the Adult Self Report at 26–27 years after the birth of the first child. Complete follow-up data were available for 168 mothers. We describe a three-group trajectory model of MDS (High Stable, Low Stable, Very Low). Elevated depressive symptom patterns were associated with less optimal maternal outcomes regarding both adaptive and problem dimensions. The child's internalizing and externalizing problem trajectories were associated with maternal internalizing and externalizing problems but not with maternal adaptive functioning. Maternal and child measures were based on maternal reports only. The interconnectedness of the well-being of the mother and child should be noted in health and mental health services for adults and children. • We present maternal depressive symptom trajectories over 27 years (1989–2017) • The maternal symptom trajectories were Very Low, Low Stable and High Stable • Low Stable trajectory predicted the best and High Stable the least optimal outcome • Child's problems predicted mother's problems but not her adaptive functioning [ABSTRACT FROM AUTHOR]

Background/aim: Migraine is a prevalent neurological disorder that can lead to disability in children and adolescents. It is frequently accompanied by psychiatric comorbidities, both internalizing and externalizing disorders. While the relationship between migraine and internalizing disorders has been studied, there is limited research on the link between migraine and attention deficit hyperactivity disorder (ADHD). Materials and methods: A total of 280 pediatric headache patients, 107 with externalizing (ADHD) and 173 with internalizing disorders (depression and/or anxiety), were included. The dataset was composed using the Turkish headache database, Mersin Branch. Pain characteristics, associated symptoms, and accompanying comorbidities were evaluated retrospectively. Results: Two hundred four patients were followed up with episodic migraine (EM) and 76 patients with chronic migraine (CM). One hundred forty-six boys and 134 girls were evaluated, and internalizing disorders were more common in the girls (p < 0.001). It was a much more prominent accompaniment in chronic migraine internalizing disorders (p = 0.038). EM, on the other hand, was more frequent in ADHD. Pain intensity and frequency were greater in those with internalizing disorders (p = 0.007), while photophobia was more prevalent in those with ADHD (OR; 0.555, p = 0.044). Moreover, we observed that individuals with internalizing disorders were predominantly female (p = 0.003) and had a higher mean age (p < 0.001) than those with externalizing disorders. Conclusion: Internalizing disorders seem to be a risk factor for migraine chronification in pediatric migraine. ADHD is a prototypic externalizing disorder more associated with EM. This outcome provides an opportunity to follow our patients in terms of prognosis and offers us the chance for a better evaluation. Identifying factors that contribute to the chronicity of migraine may lead to better management and reduced disability for migraine sufferers. [ABSTRACT FROM AUTHOR]

Objectives: This research simulates an adaptive version of the IDAS‐II (IDAS‐CAT). Methods: 2021 participants from both community (n = 1692) and patients (n = 329) samples completed the IDAS‐II. Item response theory metric properties of the IDAS‐II full test and the 20‐items of the general depression (GD) scale were obtained. The efficiency and accuracy of different computerized adaptive algorithms were simulated. Different subsamples completed additional external measures in order to gather evidence of validity of the scores estimated with the simulated adaptive algorithms selected. Results: Both unidimensional computerized adaptive testing algorithm selected for the GD scale and the bifactor model chosen for the full test, allow 70% reduction in the length of administration, maintaining a measurement error below 0.30 on the general and 0.50 on the specific factors. Results show high correlations of the scores estimated with the adaptive algorithms and the estimates based on the full test, as well as correlations with external criteria almost equal to those generated with the full test. Conclusions: IDAS‐CAT could be a reliable and fast tool for measuring internalizing spectrum. [ABSTRACT FROM AUTHOR]

This study investigated child-reported family obligation values (FOVs) in early adolescence as a moderator for associations between mother-, father-, and child-reported parental psychological control (PC) in early adolescence and child-reported internalizing and externalizing symptoms in middle and late adolescents in the Philippines. Data were drawn from three waves of a larger longitudinal study, when the Filipino youth were in late elementary grades (age M = 12.04, SD = 0.58; N = 91), in junior high school (age M = 15.03, SD = 0.59; N = 80), and in senior high school (age M = 17.00, SD = 0.59, N = 75). Results revealed that high levels of FOV buffered the positive associations between mother-reported PC and internalizing symptoms in late adolescence, and between child-reported PC and internalizing symptoms in middle and late adolescence, as well as externalizing symptoms in late adolescence. Conversely, low levels of FOV exacerbated the associations between mother- and child-reported PC on externalizing symptoms in late adolescence. Findings suggest that FOV may shape the meaning and influence of PC for children and adolescents in contexts where familial obligations are normative and important. [ABSTRACT FROM AUTHOR]

Adolescents' general growth is greatly aided by their families, which are crucial in shaping their emotional, behavioral, social, and academic outcomes and interpersonal relationships. The conflict between parents can significantly hinder this growth, leading to externalizing and internalizing behaviors and affecting their overall functioning. This study compiles pertinent data to identify IPC's dimensions, elements, and effects on adolescents. This scoping review examined the literature using both inclusion and exclusion criteria. Out of 120 relevant publications, 15 were evaluated. The publications were found in electronic databases like PubMed, Scopus, Research Gate, and Google Scholar and were published between 2016 and 2023. The search strategy adhered to Arksey and O'Malley's five-step protocol, which included formulating a research question, locating pertinent literature, choosing a subset of the literature for assessment, graphing data from particular publications, and summarizing and presenting the findings. This literature review indicates that IPC is a serious problem that results in adolescents' externalizing behaviors. The results of this scoping review have consequences for policy and practice. Given the significant extent and weight of adolescent exposure to interparental conflict, the need of the time is to develop an intervention program to protect this vulnerable population and reduce their externalizing behaviors. [ABSTRACT FROM AUTHOR]

A large body of literature has established that chaos in the home environment, characterized by high levels of disorganization, lack of household routine, crowding, noise, and unpredictability, undermines social–emotional and behavioral development in early childhood. It is less clear whether household chaos is linked to elevated risk for behavior problems in adolescence. The aims of this study were 3fold: (1) characterize the variability of adolescent and caregiver reports of household chaos over time; (2) examine associations among caregiver and adolescent reports of chaos over a 9‐month period; (3) consider how between‐ and within‐ individual variability in household chaos predicts adolescent externalizing and internalizing problems. This study drew data from the Family Income Dynamics study, a 9‐month longitudinal study. Participants included 104 adolescents between 14 and 16 years old (55% female; M age = 14.85) and their caregiver (92% female) from low‐ and middle‐income families. Results showed that adolescent‐reports of household chaos were more variable over time compared to caregivers' reports. Adolescent‐reports of household chaos had positive within‐ and between‐level associations with externalizing problems and between‐level associations with internalizing, while caregiver‐reports of chaos had no links to behavior. This work highlights the importance of adolescents' own perceptions of household chaos when considering its links to adolescent development. [ABSTRACT FROM AUTHOR]

Children who experience maltreatment are prone to exhibit interpersonal deficits and lack secure attachment, which can lead to internalizing and externalizing symptomatology. This study investigated timing and chronicity of maltreatment and its impacts on psychopathology outcomes in young adulthood. Two interpersonal mediators were examined: problems with peers and childhood attachment security. Children with and without maltreatment exposure were recruited to take part in a 1-week research summer camp (N = 697; mean [SD] age = 11.29 [0.97] years; 71.3% Black or African American; 50.5% male). Participants were recontacted in young adulthood to complete a second wave of assessments (n = 427; mean [SD] age = 19.67 [1.16] years; 78.0% Black or African American; 48.9% male). Structural equation modeling was used to estimate indirect effects from child maltreatment timing to young adult internalizing and externalizing symptomatology via childhood attachment security and peer problems. Findings highlighted the detrimental impact of chronic maltreatment, which was associated with higher levels of peer problems (β =.24, p <.001) and less secure attachment (β = −.13, p <.01) in childhood. Also, lower attachment quality in childhood mediated the association between chronic maltreatment and self-reported internalizing (a × b = 0.02, p <.05) and externalizing symptomatology (a × b = 0.02, p <.05). Additionally, childhood peer problems mediated the association between chronic maltreatment and caregiver-reported internalizing problems (a × b = 0.04, p <.05). Chronic maltreatment is particularly harmful for interpersonal outcomes of children. Mediation findings differed by who reported on psychopathology, showing the importance of considering multireporter measures of psychopathology. Child maltreatment is an interpersonal stressor that may impact developmental outcomes throughout a youth's life. In this study of 697 children who participated in a 1-week research summer camp and were contacted in young adulthood, the authors found that chronic maltreatment significantly increased the risk of difficulties in forming secure attachments as well as having problems with peers during childhood. In turn, these challenges were linked to emotional and behavioral symptomology in young adulthood. These findings emphasize the need to support children facing chronic maltreatment to improve their long-term mental health. [ABSTRACT FROM AUTHOR]

This study aimed to assess differences in emotion and elaboration quality between clinical and community child cohorts in both past reminiscing and future worry conversations. We analyzed 54 Australian parents (46 mothers, 8 fathers) and their 8- to 12-year-old children (M = 9.63, SD = 1.29; 28 boys, 26 girls) in reminiscing interactions. Dyads were recruited from local schools (community cohort, n = 26) or a children's psychology clinic waitlist (clinical cohort, n = 28). Clinical cohort children engaged in less emotion exploration in both past and future conversations, as did parents for future conversations. Elaboration quality did not differ. Parent-son dyads differed in the clinical cohort, exhibiting significantly lower emotion resolution than the community cohort, or parent-daughter dyads when discussing past events. These findings suggest that discussing anticipated negative events may be a relevant point of family-based intervention for anxious children. Additionally, this study highlights the importance of parent-son emotional discussion. [ABSTRACT FROM AUTHOR]

This longitudinal study assessed how parent-child relationship quality during the first COVID-19 lockdown was related to changes in internalizing, externalizing, and sleep problems during the first months of the pandemic: during lockdown, partial deconfinement, and total deconfinement. Participants included 167 children (9–12 year) and their parents recruited in the province of Quebec, Canada. Child behavior problems decreased between lockdown and the two deconfinement assessments, but more sleep and behavior problems were associated with lower levels of relationship quality (more conflict, less closeness, and more insecure attachment). Significant interaction effects showed that changes in externalizing and sleep problems varied as a function of parent-child relationship. Results support the critical importance of the parent-child relationship with regard to child adjustment in middle childhood in times of crisis such as a pandemic. They also highlight resilience in children aged 9 to 12, with a decrease in problems over time. [ABSTRACT FROM AUTHOR]

The influence of socio‐economic status (SES) on child temperament and psychological symptoms was examined using a nationally representative sample in Singapore. Data were available for 2169 children from 1987 families. Caregivers' reports were obtained on children aged 4–6. SES was operationalized as an aggregation of household income per capita, parental education level and housing type. Compared to their counterparts from higher SES families, children from low‐SES families tended to exhibit (a) higher negative affectivity but lower effortful control, and (b) higher internalizing and externalizing symptoms. In addition, children with a 'resilient' temperamental profile (i.e. low negative affectivity and high effortful control) were more likely to come from families with much higher SES, relative to children with other profiles. Children with high internalizing symptoms tended to come from low‐SES backgrounds, regardless of their externalizing symptoms. Among children with low internalizing symptoms, those with high externalizing symptoms came from lower SES backgrounds compared to those with low externalizing symptoms. Parental warmth and distress mediated the association between SES and child temperament and symptom profiles, with the exception of distress in the SES–temperament link. These findings supported the family stress model and highlighted the novel perspective of SES's influence on configurations of child temperament and symptom characteristics. [ABSTRACT FROM AUTHOR]

The present study investigated whether distinct developmental patterns of externalizing behaviors (EBs: hyperactivity–impulsivity, noncompliance, physical aggression) based on parent reports were repeatedly and differentially associated with separate dimensions of internalizing problems such as general anxiety, separation anxiety, and depressive symptoms across the early, middle, and late preschool years in a population birth cohort (N = 2,057, 50.7% boys). Six high trajectory classes obtained by latent growth modeling were used as longitudinal indicators of single EB and co-occurrent EBs. Children following low or moderate trajectories for all EBs served as the reference class. Results revealed that children in trajectory classes reflecting high levels of co-occurring EBs showed higher levels of general anxiety, separation anxiety, and depressive symptoms across the preschool years. In contrast, children in trajectory classes reflecting single EB manifested higher levels of some, but not all, dimensions of internalizing problems. In addition, their scores varied from one period to another. No sex differences were observed in the above associations. These results underline the need for comprehensive assessments across distinct types of EBs and internalizing problems to better reflect the characteristics that distinguish individual children. Finally, results suggest that children showing early co-occurrent EBs and internalizing symptoms may be an important group to target for in-depth assessment and possibly preventive intervention. Public Significance Statement: Children who show a high level of externalizing behaviors (EB: hyperactivity–impulsivity, noncompliance, or physical aggression) from the early to late preschool years—and especially preschoolers with high levels of multiple EBs—also present higher levels of anxiety, separation anxiety, and depressive symptoms. These findings are consistent with a developmental approach to psychopathology and emphasize the importance of early preventive evaluation and potential intervention with these children. [ABSTRACT FROM AUTHOR]

The direct associations between two dimensions of parent emotion regulation within the parent-youth relationship (dysregulation; suppression), mindful parenting, and youth internalizing and externalizing problems were examined among 759 parents of youth with significant behavioural or emotional problems. The indirect associations of parent emotion regulation and mindful parenting with youth functioning through youth attachment anxiety and avoidance were also investigated. Parent dysregulation was associated with internalizing symptoms both directly and through attachment anxiety, and with externalizing symptoms directly and through attachment anxiety and avoidance. Parent suppression was associated with internalizing symptoms through attachment anxiety, and with externalizing symptoms through attachment anxiety and avoidance. Mindful parenting was associated with lower internalizing symptoms through attachment anxiety and with lower externalizing symptoms through attachment anxiety and avoidance. Emotion regulation within parent-child relationships and mindful parenting may be critical components of parenting programs aimed at promoting youth attachment security and mental health. [ABSTRACT FROM AUTHOR]

Activation parenting includes behaviors that challenge children to approach novel situations, explore their environments, and take physical and socioemotional risks through a balance of encouragement and limit-setting. Although components of activation parenting have been linked to lower levels of children's problem behaviors, comprehensive measures of activation parenting and longitudinal research on families from low socioeconomic backgrounds are lacking. The goal of the present study was to test associations between paternal activation parenting at age 3 and children's externalizing and internalizing problems at age 5 in a sample of low-income, ethnically diverse fathers. Participating fathers (N = 171; 9% Black, 47% white, 8% Latinx; mean household income = $25,145) and their children (51% female) were drawn from the Early Steps Multisite Study. Activation parenting during a teaching task at child age 3 was associated with lower levels of internalizing problems at age 5 and decreases in externalizing problems from baseline (age 2). Implications of the current findings are presented for future research on associations between activation parenting and child problem behaviors, including the potential for the development of prevention and intervention programs. [ABSTRACT FROM AUTHOR]

Research exploring developmental explanations for sexual and/or gender minority (i.e. SGM) mental health disparities often rely on adults’ retrospectively reported childhood adversity, leaving gaps in understanding how childhood adversity affects SGM mental health disparities during critical developmental periods and/or in contemporary youth. We tested the association between 459 12- to 17-year-old Canadian adolescents’ SGM status and mental health (i.e. life satisfaction, internalizing symptoms) and whether this was explained by indirect effects of peer and family adversity. Additionally, we examined developmental differences between early and middle adolescence. SGM status significantly predicted worse mental health. In an adjusted model, indirect effects through peer and family adversity were significant; the previously detected total effect of SGM status on life satisfaction disappeared and the effect on internalizing symptoms lessened. No significant developmental differences were detected. This suggests that mental health disparities are present in contemporary SGM youth and concurrent adverse experiences may underlie these disparities.

IntroductionNumerous early-life risk factors are thought to significantly contribute to the development of psychological problems in toddlerhood. However, these factors have seldom been investigated concomitantly and longitudinally, and few studies include both mothers and fathers. This study examines the longitudinal impact of early environmental, parental, and child-specific risk factors on children’s internalizing and externalizing symptomatology at age 4.MethodsFamilies were recruited from a perinatal center at birth and completed self-report questionnaires at birth, 4 weeks postpartum, 6 months postpartum, and annually thereafter. The final population-based sample consisted of n = 560 mothers (and fathers) who gave birth after June 2015, with children who turned 4 years old before March 31, 2021. The primary outcomes, children’s internalizing and externalizing symptomatology at age 4, were measured using the Strengthsand Difficulties Questionnaire. Linear mixed effect models were used to estimate growth curves for predictors between 4 weeks and 4 years postpartum, which were subsequently entered into multivariable linear regressions to predict internalizing and externalizing symptomatology at age 4.ResultsThe study identified several key risk factors: environmental (lack of social support, lower parental education, male sex), parental (poor parental mental health, increased parenting stress, parental sleep difficulties) and child-specific (children’s low physical health, children’s reduced sleep quality, temperament).DiscussionThe findings underscore that most identified risk factors are related to children’s temperament, mental and physical health of parents, their experienced stress, and families’ social support networks. These insights highlight the importance of targeted interventions focusing on improving parental mental health, reducing stress, and enhancing social support to mitigate early-life psychological problems in children.

IntroductionThis study examines the impacts of anxiety and depressive symptoms on subsequent initiation of alcohol use, cannabis use, and prescription opioid misuse among diverse adolescents attending high schools on or near a Tribal reservation in a rural Great Plains region of the U.S.MethodsIn collaboration with Emory University and a Great Plains Tribal nation's behavioral health organization, a community randomized trial of 20 high schools was conducted to prevent substance misuse. Surveys administered at four time points (fall and spring of 10th and 11th grade) included the GAD-7, PHQ-8, and items assessing lifetime alcohol use, cannabis use, prescription opioid misuse, and covariates (age, gender, race, and food insecurity). The analytic sample included students with data at two or more time points (n = 455) from control schools (k = 10). Approximately half of the sample identified as American Indian only or American Indian/White only, and 36%–39% as White only.ResultsAdjusted generalized estimating equations showed that every 5-point increase in anxiety symptoms was associated with 1.28 and 1.29 times the odds of initiating alcohol and cannabis use respectively the following semester. Similarly, every 5-point increase in depressive symptoms was associated with 1.25, 1.34, and 1.38 times the odds of initiating alcohol use, cannabis use, and prescription opioid misuse respectively the following semester.DiscussionResults show a consistent 25%–38% increased odds of certain types of substance use initiation following increases in anxiety and depressive symptoms among adolescents. Findings underscore the need for targeted prevention and intervention to address mental health issues among a historically marginalized population. Addressing mental health concerns earlier may mitigate later substance use risks and sequelae for rural and American Indian youth.

IntroductionChildren and adolescents treated in specialty mental health services are more likely to have sleep disturbances than those without mental health problems. Few studies have investigated the relationship between sleep and psychopathology in broad clinical samples of children. We examined the relationship between sleep disturbance and age on internalizing and externalizing psychopathology in a sample who sought treatment at children's mental health centers.MethodsSecondary data analyses were completed on a sample of children (N = 13,472; aged 4 to 18; 55% male) from 39 children's mental health agencies in Ontario, Canada, who completed a semi-structured assessment, the interRAI Children and Youth Mental Health (ChYMH). A split-half sample approach was utilized (S1 n = 6,773, S2 n = 6,699). Hierarchical regressions examined the effects of sleep disturbances (i.e., difficulty falling asleep, staying asleep, night waking, bedtime resistance, falling asleep during the day) on internalizing and externalizing symptoms, above and beyond established child- (i.e., age, sex, sensory sensitivity, pain) and family-level variables (family functioning, caregiver distress, parenting strengths). Age was tested as a moderator for sleep disturbances on both outcome variables.ResultsOverall, 6.7% of children had clinically significant sleep disturbance scores (≥10 out of 16) on the interRAI ChYMH. In both samples, sleep disturbances predicted internalizing (S1 ΔR2 = 10%, S2 ΔR2 = 10%) and externalizing symptoms (S1 ΔR2 = 2%, S2 ΔR2 = 1%), above and beyond child and family variables. Age moderated the relationship between sleep disturbances and internalizing symptoms (S1 ß = 0.07; S2 ß = 0.07; ΔR2 = 0.004 in both samples), but not externalizing symptoms; sleep disturbance was more strongly related to internalizing symptoms amongst adolescents (ß = 0.98) than children (ß = 0.62).DiscussionThe relationship between sleep and internalizing symptoms appears to change as children move through development. Further, sleep was a stronger predictor of internalizing problems in adolescents than children, suggesting an additional focus of clinician efforts in this age group. These findings strengthen the importance of routine assessment of sleep, as is done with the interRAI ChYMH.

Parents/caregivers remain important in the lives of emerging adults in the modern era and understanding the ways in which parents of emerging adults balance responsiveness, demandingness, and autonomy support can help inform evidence-based recommendations around developmentally appropriate protective parenting. The present study identified four “parenting styles” in emerging adulthood in a sample of 680 4-year university and community college students (M = 19.0, ranging from 18 to 25; 70.7% female, 22.6% male) who reported on their primary parent/caregiver’s parenting behaviors. These parenting styles largely overlapped with traditional conceptualizations of parenting styles (two authoritarian profiles, a potentially indulgent profile, and a profile characterized by the average levels of all parenting behaviors measured, which may reflect the modern authoritative parenting style of emerging adults). No hypothesized overparenting profile emerged. The potentially indulgent profile saw the lowest levels of depression, mood, and anxiety symptoms, whereas the potentially indulgent and authoritative profiles saw the most positive wellbeing outcomes. The findings underscore the way in which responsiveness and autonomy support in emerging adulthood appear developmentally appropriate and adaptive, and how helicopter parenting does not appear to be as important as other aspects of parent–emerging adult relationships.

Background: Due to limitations of categorical definitions of mental illness, there is a need for quantitative empirical investigations of the dimensional structure of psychopathology. Using exploratory bifactor methods, this study investigated a comprehensive and representative structure of psychopathology in children to better understand how psychotic‐like experiences (PLEs), autism spectrum disorder (ASD) symptoms, impulsivity, and sensitivity to reward and punishment, may be integrated into extant general factor models of psychopathology. Methods: We used seven child‐report and three parent‐report instruments capturing diverse mental health symptoms in 11,185 children aged 9–10 from the Adolescent Brain Cognitive DevelopmentSM (ABCD) Study. We built on previous modeling frameworks by conducting both split sample and full sample factor analytic approaches that harnessed recent methodological advances in bifactor exploratory structural equation modeling (B‐ESEM) to examine a wide range of psychopathology measures not previously integrated into a single analysis. Validity of psychopathology dimensions was examined by investigating associations with sex, age, cognition, imaging measures, and medical service usage. Results: All four factor analytic models showed excellent fit and similar structure within informant. PLEs loaded most highly onto a general psychopathology factor, suggesting that they may reflect non‐specific risk for mental illness. ASD symptoms loaded separately from attention/hyperactivity symptoms. Symptoms of impulsivity and sensitivity to reward and punishment loaded onto specific factors, distinct from externalizing and internalizing factors. All identified factors were associated with clinically relevant risk factors, providing preliminary evidence for their construct validity. Conclusion: By integrating diverse child‐report and parent‐report psychopathology measures for children in the ABCD sample, we deliver data on the quantitative structure of psychopathology for an exceptionally large set of measurements and discuss implications for the field. [ABSTRACT FROM AUTHOR]

Adolescent anhedonia is a multidimensional construct defined as the loss of enjoyment or pleasure across multiple domains of life. Anhedonia is concurrently associated with substantial impairment and distress, and it prospectively predicts the onset, severity, and treatment of depression. Despite its demonstrated importance, a limited number of anhedonia measures are validated for adolescents. The current study assessed the psychometric properties of the Dimensional Anhedonia Rating Scale (DARS) in 400 English-speaking, 12- to 19-year-old adolescents. Overall, the DARS demonstrated good convergent and discriminant validity, but sub-optimal concurrent validity. The strengths and limitations of the DARS and its utility as a measure of adolescent anhedonia are discussed. Furthermore, future directions for the construction of measures of adolescent anhedonia are outlined. [ABSTRACT FROM AUTHOR]

Children of parents with emotion regulation (ER) difficulties may be at heightened risk for internalizing and externalizing problems, and maternal invalidation may explain this association. The current study used a cross-informant design to test the indirect effect of clinician-rated maternal ER difficulties on teacher-reported internalizing and externalizing problems through maternal invalidation. This risk pathway was tested in two groups of preschoolers: children of mothers with ER difficulties and children of mothers without ER difficulties (healthy controls; HC). Participants were 85 mothers (Mage =33.30 years; 36% racial/ethnic minoritized status) and their children (Mage =4234 months; 47% racial/ethnic minoritized status). Maternal ER difficulties had a significant indirect effect on child internalizing problems and externalizing problems, specifically aggressive behavior, through maternal invalidation. Specifically, mothers with ER difficulties reported more maternal invalidation, and their children exhibited more internalizing problems and aggressive behavior in a preschool/daycare setting, pointing to multiple avenues for prevention and intervention. [ABSTRACT FROM AUTHOR]

Racial oppression in the United States has changed many forms post-2016 elections, including anti-immigrant sentiments towards highly visible immigrant communities, such as Latinx and Asian people. The weaponization of immigration status against Latinx and Asian people in the U.S. has increased drastically post-2016 and equity researchers have responded with scholarship primarily addressing the systemic and macro levels of these oppressive behaviors. Less is known during this period about the shifts of everyday racism-related attacks — such as racial microaggressions. Racial microaggressions are daily stressors that can severely impact the targets' well-being and people of color often engage in coping strategies to disarm and neutralize these stressors. The internalization of these degrading and stereotypical messages is a common coping strategy with people of color adopting these negative images into their self-view. Using a sample (N = 436) collected in the Fall of 2020, we unpack the relationships between immigration status microaggressions, psychological distress, and internalization among Latinx and Asian college students. We compared the frequencies of immigration status microaggressions and psychological distress between Latinx and Asian respondents. We used a conditional (moderated mediation) process model to explore possible significant interactions. Our findings suggested that Latinx, compared to Asian students, significantly reported more experiences of immigration status microaggressions and psychological distress. A mediation analysis showed that internalizing coping strategies partially mediated the relationship between immigration status microaggressions and poor well-being. Finally, a moderated mediation model's results highlighted that being Latinx moderated the positive relationship between immigration status microaggressions and psychological distress through internalization. [ABSTRACT FROM AUTHOR]

Parents/caregivers remain important in the lives of emerging adults in the modern era and understanding the ways in which parents of emerging adults balance responsiveness, demandingness, and autonomy support can help inform evidence-based recommendations around developmentally appropriate protective parenting. The present study identified four "parenting styles" in emerging adulthood in a sample of 680 4-year university and community college students (M = 19.0, ranging from 18 to 25; 70.7% female, 22.6% male) who reported on their primary parent/caregiver's parenting behaviors. These parenting styles largely overlapped with traditional conceptualizations of parenting styles (two authoritarian profiles, a potentially indulgent profile, and a profile characterized by the average levels of all parenting behaviors measured, which may reflect the modern authoritative parenting style of emerging adults). No hypothesized overparenting profile emerged. The potentially indulgent profile saw the lowest levels of depression, mood, and anxiety symptoms, whereas the potentially indulgent and authoritative profiles saw the most positive wellbeing outcomes. The findings underscore the way in which responsiveness and autonomy support in emerging adulthood appear developmentally appropriate and adaptive, and how helicopter parenting does not appear to be as important as other aspects of parent–emerging adult relationships. [ABSTRACT FROM AUTHOR]

School absenteeism among children and adolescents has been associated with a myriad of adverse outcomes. Despite a substantial amount of research on school attendance, our understanding of absenteeism in elementary-aged children with mental health difficulties is limited. The current study used a mixed-method sequential explanatory design to gain a better understanding of the links between children's mental health symptoms, age, gender and school absenteeism. The study included two phases: Phase I presented a quantitative investigation of the links between absenteeism and mental health symptoms in a large sample (N = 750) of primarily White (74%) clinic-referred children aged 5–12 years. Phase II used a participant selection model and chart review design to garner a deeper understanding of how school absenteeism presents in children with mental health problems in the elementary years. Results suggested that internalizing symptoms were significantly related to school attendance problems, and this association worsens as children age and as internalizing symptoms increase in severity. Externalizing symptoms were associated with absenteeism as well, but these findings showed that school attendance problems were worse for younger children with low to moderate levels of externalizing symptoms. The qualitative chart review illustrates the complex interplay of school absenteeism and child mental health, particularly for children experiencing co-occurring internalizing and externalizing problems. Children often struggled academically and socially, with some exhibiting increasing levels of school refusal and truancy and others displaying aggressive behaviors resulting in suspensions. Future studies that examine additional contextual factors, such as school and family variables, with longitudinal cross-lagged models and diverse families are needed to develop a comprehensive understanding of causal associations and their impact on children's school attendance across children's development. [ABSTRACT FROM AUTHOR]

Social anxiety is associated with alterations in socioemotional processing, but the pathophysiology remains poorly understood. Movies present an opportunity to examine more naturalistic socioemotional processing by providing narrative and sensory context to emotion cues. This study aimed to characterize associations between neural response to contextualized social cues and social anxiety symptoms in children. Data from the Healthy Brain Network (final N = 740; age range 5-15 years) were split into discovery and replication samples to maximize generalizability of findings. Associations of parent- and self-reported social anxiety (Screen for Child Anxiety-related Emotional Disorders) with mean differences and person-to-person variability in functional magnetic resonance imaging–measured activation to 2 emotionally dynamic movies were characterized. Though no evidence was found to indicate social anxiety symptoms were associated with mean differences in neural activity to emotional content (fit Spearman r s < 0.09), children with high social anxiety symptoms had higher intersubject activation variability in the posterior cingulate, supramarginal gyrus, and inferior frontal gyrus (Bonferroni familywise error–corrected p s <.05)—regions associated with attention, alertness, and emotion cue processing. Identified regions varied by age group and informant. Across ages, these effects were enhanced for scenes containing greater sensory intensity (brighter, louder, more motion, more vibrance). These results provide evidence that children with high social anxiety symptoms show high person-to-person variability in the neural processing of sensory aspects of emotional content. These data indicate that children with high social anxiety may require personalized interventions for sensory and emotional difficulties, as the underlying neurology differs from child to child. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. [ABSTRACT FROM AUTHOR]

To examine the additive or moderating influences of caregiver COVID-19–related stress, social support, and discrimination on children's behavior problems across racially diverse populations. In this Environmental influences on Child Health Outcomes (ECHO) cohort study (N = 1,999 caregiver/child pairs), we operationalized caregiver COVID-19–related stress in 2 ways: first, as the number of stressors (eg, financial concerns, social distancing); and second, as the level of pandemic-related traumatic stress symptoms reported via questionnaires administered between April 2020 and August 2022. At the same assessment visit, caregivers also reported their current levels of discrimination, and a subsample (n = 968) reported their emotional and instrumental support. Either concurrently or at a later assessment visit, caregivers reported on their children's internalizing and externalizing behavior problems using the Child Behavior Checklist for Ages 6-18 (CBCL/6-18). Multivariable analyses controlling for maternal education, marital status, child age, and child sex revealed that COVID-19–related stress (caregiver stressors and symptoms) and discrimination were positively associated, and that perceived support was negatively associated with child internalizing and externalizing behavior problems. Unexpectedly, neither emotional nor instrumental support attenuated the relationship between caregiver COVID-19–related stressors nor traumatic stress symptoms and child behavior problems. In the subset of Black American participants, caregiver perceived discrimination moderated the relationship between caregiver COVID-19 traumatic stress symptoms and child internalizing problems, such that the association was stronger at higher levels of discrimination. Our findings highlight the potential importance of relieving caregiver stress and increasing caregiver social support to optimize children's behavioral outcomes. [ABSTRACT FROM AUTHOR]

This study examined parents' report of behaviour in preschoolers after a mild traumatic brain injury (mTBI), compared the proportion of preschoolers with elevated behaviour ratings between the mTBI and limb injury (LI) groups, and explored injury, premorbid child, and parent variables that may be associated with parents' report of behaviour at three months post-injury. Children aged 2–5 years with a mTBI (n = 13) or mild LI (n = 6) were recruited from the emergency department. Behaviour was assessed using the Child Behaviour Checklist. Preliminary findings showed that post-injury behaviour ratings remained in the normal range. The mTBI group had higher scores than the LI group at three months post-injury in terms of sleep; however, this may have been pre-existing. Two children with mTBI received borderline-clinically significant ratings on diagnostic-level anxiety problems at the three-month follow-up, while none of the limb-injured controls obtained elevated behaviour ratings. Parent-rated post-injury behaviour was significantly associated with premorbid child functioning and parental stress, which needs to be explored in greater detail using larger preschool mTBI samples. [ABSTRACT FROM AUTHOR]

The ongoing war in Ukraine is expected to negatively impact the mental health of the country's population. This study aims to provide a preliminary estimate of the degree of change in the mental health problems of Ukrainian children following Russia's invasion in February 2022, and to identify the sociodemographic and war-related risk factors associated with these changes. A nationwide, opportunistic sample of 1238 parents reported on a single randomly chosen child within their household as part of The Mental Health of Parents and Children in Ukraine Study. Data were collected between July 15th and September 5th, 2022. Participants completed modified versions of the Pediatric Symptom Checklist (PSC-17) which was adapted to capture change in the frequency of symptoms since the beginning of the war. Parents reported increases across all 17 indicators of internalizing, externalizing, and attention problems of the PSC-17. Increased problems were most pronounced within the internalizing domain, with 35% of parents reporting that their child worried more since the beginning of the war. A number of individual, parental, and war-related factors were associated with increases across the three domains. Exposure to war trauma, pre-existing mental health problems, and child age were among the strongest predictors of change. This survey provides preliminary evidence that the Russian war on Ukraine has led to an increase in common mental health problems among children in the general population. Further research is required to determine the extent and sequela of this increase, and to develop intervention strategies for those most in need. [ABSTRACT FROM AUTHOR]

Childhood anxiety and depression symptoms are potential risk factors for accelerated biological aging. In child and adolescent twins, we tested whether these symptoms were associated with DNA methylation (DNAm) aging, a measure of biological aging. 276 twins (135 pairs, 6 singletons) had DNAm assayed from saliva in middle childhood (mean = 7.8 years). Residuals of five different DNAm age estimates regressed on chronological age were used to indicate accelerated aging. Anxiety and depression symptoms were assessed in middle childhood and early adolescence using the Child Behavior Checklist. Mixed effect regression was used to examine potential relationships between anxiety or depression symptoms, and accelerated DNAm age. MZ twin difference analysis was then utilized to determine if associations were environmentally-driven or due to genetic or shared-environment confounding. Anxiety and depression symptoms were not associated with accelerated DNAm aging in middle childhood. In early adolescence, only the Wu clock was significant and indicated that each one symptom increase in anxiety symptoms had an associated age acceleration of 0.03 years (~0.4 months; p = 0.019). MZ twin difference analysis revealed non-significant within-pair effects, suggesting genetic and shared environmental influences. Sample is predominantly male and white. Generalizability to other populations may be limited. Accelerated DNAm aging of the Wu clock in middle childhood is associated with anxiety, but not depression, symptoms in early adolescence. Further, this association may be the result of shared genetic and environmental influences. Accelerated DNAm aging may serve as an early risk factor or predictor of later anxiety symptoms. • We explored the relationship between anxiety and depression symptoms, and DNA methylation aging in young twins. • Accelerated DNA methylation aging in childhood is associated with anxiety, but not depression, symptoms in adolescence. • Twin difference analysis suggests this association reflects genetic and shared environmental confounding. [ABSTRACT FROM AUTHOR]

Parenting can protect against the development of, or increase risk for, child psychopathology; however, it is unclear if parenting is related to psychopathology symptoms in a specific domain, or to broad liability for psychopathology. Parenting differs between and within families, and both overall family-level parenting and the child-specific parenting a child receives may be important in estimating transdiagnostic associations with psychopathology. Data come from a cross-sectional epidemiological sample (N = 10,605 children ages 4–17, 6434 households). Parents rated child internalizing and externalizing symptoms and their parenting toward each child. General and specific (internalizing, externalizing) psychopathology factors, derived with bifactor modeling, were regressed on parenting using multilevel modeling. Less warmth and more aversive/inconsistent parenting in the family, and toward an individual child relative to family average, were associated with higher general psychopathology and specific externalizing problems. Unexpectedly, more warmth in the family, and toward an individual child relative to family average, was associated with higher specific internalizing problems in 4–11 (not 12–17) year-olds. Less warmth and more aversive/inconsistent parenting are broad correlates of child psychopathology. Aversive/inconsistent parenting, is also related to specific externalizing problems. Parents may behave more warmly when their younger children have specific internalizing problems, net of overall psychopathology. [ABSTRACT FROM AUTHOR]

The early caregiving environment can have lasting effects on child mental health. Animal models suggest that glucocorticoid receptor gene (NR3C1) DNA methylation plays a mediating role in linking more responsive caregiving to improved behavioral outcomes by its impact on the stress regulatory system. In this longitudinal study, we examined whether children's NR3C1 methylation levels mediate an effect of maternal sensitivity in infancy on levels of child internalizing and externalizing behavior in a community sample. Maternal sensitivity of 145 mothers was rated at infant age 5 weeks, 12 months, and 30 months by observing mother–infant interactions. Buccal DNA methylation was assessed in the same children at age 6 years and maternal-reported internalizing and externalizing behavior was assessed at age 6 and 10 years. Higher sensitivity at age 5 weeks significantly predicted lower DNA methylation levels at two NR3C1 CpG loci, although methylation levels at these loci did not mediate an effect of maternal sensitivity on levels of child internalizing and externalizing behavior. Overall, the study provides evidence that maternal sensitivity in early infancy is associated with DNA methylation levels at loci involved in stress regulation, but the significance of this finding for child mental health remains unclear. [ABSTRACT FROM AUTHOR]

Internalizing and externalizing problems that emerge during adolescence differentially increase boys' and girls' risk for developing psychiatric disorders. It is not clear, however, whether there are sex differences in the intrinsic functional architecture of the brain that underlie changes in the severity of internalizing and externalizing problems in adolescents. Using resting-state fMRI data and self-reports of behavioral problems obtained from 128 adolescents (73 females; 9–14 years old) at two timepoints, we conducted multivoxel pattern analysis to identify resting-state functional connectivity markers at baseline that predict changes in the severity of internalizing and externalizing problems in boys and girls 2 years later. We found sex-differentiated involvement of the default mode network in changes in internalizing and externalizing problems. Whereas changes in internalizing problems were associated with the dorsal medial subsystem in boys and with the medial temporal subsystem in girls, changes in externalizing problems were predicted by hyperconnectivity between core nodes of the DMN and frontoparietal network in boys and hypoconnectivity between the DMN and affective networks in girls. Our results suggest that different neural mechanisms predict changes in internalizing and externalizing problems in adolescent boys and girls and offer insights concerning mechanisms that underlie sex differences in the expression of psychopathology in adolescence. [ABSTRACT FROM AUTHOR]

The Gaza Strip is a notoriously high-conflict area, but few large-scale studies have examined the rates of psychiatric distress and emotional/behavioral problems among Gaza youth, and there are few trauma-informed, scaleable intervention options. Studies in existence have used smaller samples or have examined focal problems such as posttraumatic stress disorder (PTSD) or aggression. Here, we examine the mental health burden of young individuals (ages 8-13) in Gaza across a broad range of symptoms, and demonstrate the impact of a community-based, trauma-informed program, Eye to the Future. At the outset of this supportive youth program, over 2000 children and adolescent youth and their parents reported on child well-being using standardized measures with established global norms (the Child Behavior Checklist and Youth Self Report). These measures examine symptoms broadly (e.g. anxiety, depression, social problems, attention problems, aggression, etc.). Relative to U.S. population estimates, children in Gaza had between 2.5- and 17-times higher point prevalence of clinical mental health problems. The most significant clinical concern was anxiety, but overall, their symptoms were not confined to posttraumatic stress as a disorder and were instead broadly dispersed. However, these concerns were responsive to intervention: over the course of a six-month community psychosocial program, symptoms ameliorated, with approximately 50–70% showing reliable improvement at post-program (varying by measure). These gains were maintained in a 9-month follow-up. Future work should consider the broader mental health impact, beyond PTSD and aggression, and incorporate community supports into addressing mental health among children in the region. [ABSTRACT FROM AUTHOR]

During late childhood and early adolescence, youth experience heightened stress exposure and rates of mental health disorders, emphasizing the need to investigate how youth cope with stress as a potential mechanism of risk and/or resilience. This study examined youths' age, gender, and peer-related stress exposure as moderators of the relationships among coping and anxious/depressed symptoms during this important developmental period. To sample participants with a broad range of internalizing psychopathology symptoms, a community sample of 120 older children and adolescents (46% female, M age = 12.28) was recruited through mental health clinics and a university-based study finder in a southeastern metropolitan area. Participants completed a battery of questionnaires assessing coping strategies, stress exposure, demographic information, and anxious/depressed symptoms in a cross-sectional study. Analyses included interactions among age, gender, and peer stress as predictors of youths' coping strategies and anxious/depressed symptoms. There were significant associations between age, gender, coping strategies, and symptoms, where girls reported more anxiety and depression symptoms compared to boys, and primary and secondary control coping strategy use increased with age. The findings expand upon previous studies by showing gender differences in the relation among secondary control coping and internalizing problems at different ages. Additionally, findings demonstrate that degrees of peer stress exposure show associations with disengagement coping across development, which may contribute to the onset of internalizing symptoms in older girls. Findings may be used to inform interventions by promoting the use of more adaptive forms of coping to prevent internalizing disorders in youth. Limitations and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Individuals with depression who do not respond to two or more courses of serotonergic antidepressants tend to have greater deficits in reward processing and greater internalizing symptoms, yet there is no validated self-report method to determine the likelihood of treatment resistance based on these symptom dimensions. Methods: This online case-control study leverages machine learning techniques to identify differences in self-reported anhedonia and internalizing symptom profiles of antidepressant non-responders compared to responders and healthy controls, as an initial proof-of-concept for relating these indicators to medication responsiveness. Random forest classifiers were used to identify a subset from a set of 24 reward predictors that distinguished among serotonergic medication resistant, non-resistant, and non-depressed individuals recruited online (N = 393). Feature selection was implemented to refine model prediction and improve interpretability. Results: Accuracies for full predictor models ranged from .54 to .71, while feature selected models retained 3-5 predictors and generated accuracies of .42 to .70. Several models performed significantly above chance. Sensitivity for non- responders was greatest after feature selection when compared to only responders, reaching .82 with 3 predictors. The predictors retained from feature selection were then explored using factor analysis at the item level and cluster analysis of the full data to determine empirically driven data structures. Discussion: Non-responders displayed 3 distinct symptom profiles along internalizing dimensions of anxiety, anhedonia, motivation, and cognitive function. Results should be replicated in a prospective cohort sample for predictive validity; however, this study demonstrates validity for using a limited anhedonia and internalizing self-report instrument for distinguishing between antidepressant resistant and responsive depression profiles. [ABSTRACT FROM AUTHOR]