Dynamic Associations Between Anxiety Symptoms and Drinking Behavior From Early Adolescence to Young Adulthood.

PURPOSE: Research is inconclusive with respect to the possible risk-increasing effect of anxiety symptoms on heavy drinking behavior among adolescents and young adults. Adult role transitions and changes in the social context from early adolescence into young adulthood may impact the association between anxiety symptoms and alcohol use. METHODS: The TRacking Adolescents' Individual Lives Survey, including 2,229 individuals at baseline, was used to evaluate the bi-directional and longitudinal associations between anxiety symptoms and alcohol use, using data at 14, 16, 19, 22, and 25 years of age. RESULTS: Cross-lagged models revealed a relatively stable negative association at 14, 16, and 19 years, showing that relatively higher anxiety symptoms were associated with relatively lower drinking levels three years later. This effect was absent in young adulthood. There was no evidence for significant associations between alcohol use and subsequent anxiety symptoms, with the exception of alcohol use at age 19, which predicted relatively lower levels of anxiety symptoms at age 22. DISCUSSION: Overall, the results indicated that anxiety symptoms may withhold adolescents from (heavy) drinking, although this protective effect disappeared in young adulthood. Transitions in social contexts as well as autonomy and adult responsibilities could underlie the changing association between alcohol use and anxiety symptoms throughout adolescence and young adulthood.

Disentangling the interplay between genes, cognitive skills, and educational level in adolescent and young adult smoking - The TRAILS study.

Recent studies suggest that smoking and lower educational attainment may have genetic influences in common. However, little is known about the mechanisms through which genetics contributes to educational inequalities in adolescent and young adult smoking. Common genetic liabilities may underlie cognitive skills associated with both smoking and education, such as IQ and effortful control, in line with indirect health-related selection explanations. Additionally, by affecting cognitive skills, genes may predict educational trajectories and hereby adolescents' social context, which may be associated with smoking, consistent with social causation explanations. Using data from the Dutch TRAILS Study (N = 1581), we estimated the extent to which polygenic scores (PGSs) for ever smoking regularly (PGSSMOK) and years of education (PGSEDU) predict IQ and effortful control, measured around age 11, and whether these cognitive skills then act as shared predictors of smoking and educational level around age 16, 19, 22, and 26. Second, we assessed if educational level mediated associations between PGSs and smoking. Both PGSs were associated with lower effortful control, and PGSEDU also with lower IQ. Lower IQ and effortful control, in turn, predicted having a lower educational level. However, neither of these cognitive skills were directly associated with smoking behaviour after controlling for covariates and PGSs. This suggests that IQ and effortful control are not shared predictors of smoking and education (i.e., no indirect health-related selection related to cognitive skills). Instead, PGSSMOK and PGSEDU, partly through their associations with lower cognitive skills, predicted selection into a lower educational track, which in turn was associated with more smoking, in line with social causation explanations. Our findings suggest that educational differences in the social context contribute to associations between genetic liabilities and educational inequalities in smoking.

Decline in positive future orientations among adolescents during covid-19: The role of socioeconomic status, parental support, and sense of control.

INTRODUCTION: Before coronavirus disease (covid-19), adolescents from a lower socioeconomic status (SES) background tend to have less positive future orientations, receive less parental support, and have a weaker sense of control than adolescents from a higher SES background. The covid-19 pandemic has potentially increased the socioeconomic gaps in positive future orientations, parental support, and sense of control among adolescents who are currently in vocational education. As societies are aiming to return back to precovid norms, certain groups of adolescents might require more attention for ensuring a stable future than others. METHODS: Two-wave questionnaire data of 689 Dutch adolescents (Mage = 17.8; 56% female) from the Youth Got Talent project was analyzed. Latent Change Score models are a relatively novel approach that allows two-wave data to estimate associations between precovid predictor variables and changes in outcome variables from before to during covid-19 (e.g., SES, positive future orientations, parental support, and sense of control). Analyses were preregistered. RESULTS: The precovid socioeconomic differences in adolescent's positive future orientations and sense of control remained stable during covid-19, whereas the socioeconomic difference in parental support decreased during covid-19. A decline in parental support, an increase in sense of control, and more covid-19 hardships were associated with an increase in future orientations. CONCLUSION: The covid-19 situation has not substantially increased socioeconomic differences in positive future orientations and sense of control, but did decrease socioeconomic differences in parental support among adolescents. Short-term policies should aim to facilitate parental support and positive future orientations to all adolescents who experienced a decline, while also long-term focusing on the more consistent socioeconomic difference in sense of control among adolescents.

A cross-sectional study on gaming intensity and social vulnerability in adolescents that have a chronic condition.

Background: Adolescents growing up with a chronic condition might experience more social vulnerabilities compared to their healthy peers as an indirect result of their conditions. This can lead to a relatedness need frustration for these adolescents. Consequently, they might spend more time playing video games compared to their peers. Research shows that both social vulnerability and gaming intensity are predictors for problematic gaming. Therefore, we investigated if social vulnerability and gaming intensity are more pronounced in adolescents that have a chronic condition compared to the general population; and if these levels reflect the levels of a clinical group being treated for Internet Gaming Disorder (IGD). Methods: Data on peer problems and gaming intensity were compared from three separate samples: a national representative sample of adolescents, a clinical sample of adolescents that are undergoing treatment for IGD, and a sample of adolescents diagnosed with a chronic condition. Results: No differences were found on either peer problems or gaming intensity between the group of adolescents that have chronic conditions and the national representative group. The group with chronic conditions scored significantly lower on gaming intensity than the clinical group. No significant differences were found between these groups on peer problems. We repeated the analyses for boys only. Similar results were found for the group with chronic conditions compared to the national representative group. The group with chronic conditions now scored significantly lower on both peer problems and gaming intensity than the clinical group. Conclusion: Adolescents growing up with a chronic condition appear similar in their gaming intensity and peer problems compared to their healthy peers.

A cross-national comparison of problematic gaming behavior and well-being in adolescents.

BACKGROUND AND AIMS: The popularity of playing games among adolescents has increased during the last decades, possibly affecting the prevalence of problematic gaming behavior. The current study aimed to compare country-level prevalence rates of adolescents' problematic gaming behavior in five countries and identify cross-cultural similarities and differences in the relationship between problematic gaming and well-being (life satisfaction, psychological complaints, and peer support). METHODS: Cross-national data from the Health Behavior in School-aged Children (HBSC) study were used. The sample comprised 14,398 gamers (61% boys) aged 11 to 16 (average age between 13.31 and 13.85) from Azerbaijan, England, Serbia, Slovenia, and the Netherlands. RESULTS: The findings showed that the prevalence of problematic gaming differs between countries. The highest prevalence of problematic gaming was seen in Azerbaijan (16.1%) and the lowest in the Netherlands (4.3%). In contrast, Azerbaijan reported the lowest gaming intensity, whereas the Netherlands and England showed the highest gaming intensity. Additional analyses revealed that problematic gaming was associated with lower life satisfaction, more psychological complaints, and lower peer support in all countries, although the strength of these associations varied between countries. DISCUSSION AND CONCLUSIONS: The current study's results are consistent with the assumption that problematic gaming negatively affects adolescents' social and mental well-being. These findings are further discussed in light of the normalization theory which suggests that cultural gaming norms (i.e., the percentage of gamers per country) would influence the strength of the relationship between problematic gaming and adolescents' well-being. The present findings highlight the need for adequate prevention strategies aiming at problematic gaming among youngsters.

ADHD Symptoms and Educational Level in Adolescents: The Role of the Family, Teachers, and Peers.

Few studies have explored the contribution of family and school factors to the association between ADHD symptoms and lower education. Possibly, having more ADHD symptoms contributes to poorer family functioning and less social support, and consequently a lower educational level (i.e., mediation). Moreover, the negative effects of ADHD symptoms on education may be stronger for adolescents with poorer family functioning or less social support (i.e., interaction). Using data of the Dutch TRAILS Study (N = 2,229), we evaluated associations between ADHD symptoms around age 11 and educational level around age 14, as well as between ADHD symptoms around age 14 and 16 years and subsequent changes in educational level around age 16 and 19, respectively. We assessed the potential mediating role of family functioning, and social support by teachers and classmates, all measured around ages 11, 14, and 16, while additionally evaluating interactions between ADHD symptoms and these hypothesized mediators. ADHD symptoms were associated with poorer family functioning, less social support by teachers and classmates, and lower education throughout adolescence. No conclusive evidence of mediation was found, because unique associations between family functioning and social support by teachers and classmates and education were largely absent. Furthermore, we found no interactions between ADHD symptoms and family functioning and social support by teachers and classmates. Although social support by teachers and classmates and good family functioning may benefit the wellbeing and mental health of adolescents with high levels of ADHD symptoms, they will not necessarily improve their educational attainment.

The role of social cognitions in the social gradient in adolescent mental health: A longitudinal mediation model.

The social gradient in adolescent mental health is well established: adolescents' socioeconomic status is negatively associated with their mental health. However, despite changes in social cognition during adolescence, little is known about whether social cognitions mediate this gradient. Therefore, this study tested this proposed mediational path using three data waves, each 6 months apart, from a socioeconomically diverse sample of 1,429 adolescents (Mage = 17.9) in the Netherlands. Longitudinal modeling examined whether three social cognitions (self-esteem, sense of control, and optimism) mediated associations between perceived family wealth and four indicators of adolescent mental health problems (emotional symptoms, conduct problems, hyperactivity, and peer problems). There was evidence of a social gradient: adolescents with lower perceived family wealth reported more concurrent emotional symptoms and peer problems and an increase in peer problems 6 months later. Results also showed evidence of mediation through social cognitions, specifically sense of control: adolescents with lower perceived family wealth reported a decrease in sense of control (though not self-esteem nor optimism) 6 months later, and lower sense of control predicted increases in emotional symptoms and hyperactivity 6 months later. We found concurrent positive associations between perceived family wealth and all three social cognitions, and concurrent negative associations between social cognitions and mental health problems. The findings indicate that social cognitions, especially sense of control, may be an overlooked mediator of the social gradient in adolescent mental health.

Educational level, attention problems, and externalizing behaviour in adolescence and early adulthood: the role of social causation and health-related selection-the TRAILS study.

Social causation and health-related selection may contribute to educational differences in adolescents' attention problems and externalizing behaviour. The social causation hypothesis posits that the social environment influences adolescents' mental health. Conversely, the health-related selection hypothesis proposes that poor mental health predicts lower educational attainment. From past studies it is unclear which of these mechanisms predominates, as attention problems and externalizing behaviour have the potential to interfere with educational attainment, but may also be affected by differences in the educational context. Furthermore, educational gradients in mental health may reflect the impact of 'third variables' already present in childhood, such as parental socioeconomic status (SES), and IQ. We investigated both hypotheses in relation to educational differences in externalizing behaviour and attention problems throughout adolescence and young adulthood. We used data from a Dutch cohort (TRAILS Study; n = 2229), including five measurements of educational level, externalizing behaviour, and attention problems from around age 14-26 years. First, we evaluated the directionality in longitudinal associations between education, externalizing behaviour, and attention problems with and without adjusting for individual differences using fixed effects. Second, we assessed the role of IQ and parental SES in relation to attention problems, externalizing behaviour, and educational level. Attention problems predicted decreases in education throughout all of adolescence and young adulthood. Differences in parental SES contributed to increases in externalizing behaviour amongst the lower educational tracks in mid-adolescence. Childhood IQ and parental SES strongly predicted education around age 14. Parental SES, but not IQ, also predicted early adolescent attention problems and externalizing behaviour. Our results provide support for the health-related selection hypothesis in relation to attention problems and educational attainment. Further, our results highlight the role of social causation from parental SES in determining adolescent educational level, attention problems, and externalizing behaviour.

The social gradient in adolescent mental health: mediated or moderated by belief in a just world?

PURPOSE: A social gradient in adolescent mental health exists: adolescents with higher socioeconomic status (SES) have fewer mental health problems than their peers with lower SES. Little is known about whether adolescents' societal beliefs play a role in this social gradient. Belief in a just world (BJW) may be a mediator or moderator of the social gradient in adolescent mental health. METHODS: Using data from 848 adolescents (Mage = 17) in the Netherlands, path analyses examined whether two indicators of BJW (general and personal) mediated or moderated the associations between two indicators of SES (family affluence and perceived family wealth), and four indicators of adolescent mental health problems (emotional symptoms, conduct problems, hyperactivity, and peer problems). RESULTS: Adolescents with lower family affluence and lower perceived family wealth reported more emotional symptoms, and the association between perceived family wealth and emotional symptoms was mediated by lower personal and general BJW. Furthermore, higher personal BJW amplified the negative association between SES and peer problems. CONCLUSION: This study suggests BJW may both mediate and amplify the social gradient in adolescent mental health. Adolescents' beliefs about society may be important to include in research aimed at understanding this social gradient.

Socioeconomic inequalities in adolescent health behaviours across 32 different countries - The role of country-level social mobility.

Higher family affluence is associated with healthier behaviours in adolescents, but the strength of this association varies across countries. Differences in social mobility at the country-level, i.e. the extent to which adolescents develop a different socioeconomic status (SES) than their parents, may partially explain why the association between family affluence and adolescent health behaviours is stronger in some countries than in others. Using data from adolescents aged 11-15 years from 32 countries, participating in the 2017/2018 wave of the Health Behaviour in School-aged Children (HBSC) study (N = 185,086), we employed multilevel regression models with cross-level interactions to examine whether country-level social mobility moderates the association between family affluence and adolescent health behaviours (i.e. moderate-to-vigorous physical activity, vigorous physical activity, healthy and unhealthy foods consumption, having breakfast regularly, and weekly smoking). Higher family affluence was more strongly associated with higher levels of adolescent physical activity in countries characterized by high levels of social mobility. No cross-level interactions were found for any of the other health behaviours. Differences in social mobility at the country-level may contribute to cross-national variations in socioeconomic inequalities in adolescent physical activity. Further research can shed light on the mechanisms linking country-level social mobility to inequalities in adolescent physical activity to identify targets for policy and interventions.

Educational level and alcohol use in adolescence and early adulthood-The role of social causation and health-related selection-The TRAILS Study.

Both social causation and health-related selection may influence educational gradients in alcohol use in adolescence and young adulthood. The social causation theory implies that the social environment (e.g. at school) influences adolescents' drinking behaviour. Conversely, the health-related selection hypothesis posits that alcohol use (along other health-related characteristics) predicts lower educational attainment. From past studies it is unclear which of these mechanisms predominates, as drinking may be both a cause and consequence of low educational attainment. Furthermore, educational gradients in alcohol use may reflect the impact of 'third variables' already present in childhood, such as parental socioeconomic status (SES), effortful control, and IQ. We investigated social causation and health-related selection in the development of educational gradients in alcohol use from adolescence to young adulthood in a selective educational system. We used data from a Dutch population-based cohort (TRAILS Study; n = 2,229), including measurements of educational level and drinking at ages around 14, 16, 19, 22, and 26 years (waves 2 to 6). First, we evaluated the directionality in longitudinal associations between education and drinking with cross-lagged panel models, with and without adjusting for pre-existing individual differences using fixed effects. Second, we assessed the role of childhood characteristics around age 11 (wave 1), i.e. IQ, effortful control, and parental SES, both as confounders in these associations, and as predictors of educational level and drinking around age 14 (wave 2). In fixed effects models, lower education around age 14 predicted increases in drinking around 16. From age 19 onward, we found a tendency towards opposite associations, with higher education predicting increases in alcohol use. Alcohol use was not associated with subsequent changes in education. Childhood characteristics strongly predicted education around age 14 and, to a lesser extent, early drinking. We mainly found evidence for the social causation theory in early adolescence, when lower education predicted increases in subsequent alcohol use. We found no evidence in support of the health-related selection hypothesis with respect to alcohol use. By determining initial educational level, childhood characteristics also predict subsequent trajectories in alcohol use.

Bayesian evidence synthesis in case of multi-cohort datasets: An illustration by multi-informant differences in self-control.

The trend toward large-scale collaborative studies gives rise to the challenge of combining data from different sources efficiently. Here, we demonstrate how Bayesian evidence synthesis can be used to quantify and compare support for competing hypotheses and to aggregate this support over studies. We applied this method to study the ordering of multi-informant scores on the ASEBA Self Control Scale (ASCS), employing a multi-cohort design with data from four Dutch cohorts. Self-control reports were collected from mothers, fathers, teachers and children themselves. The available set of reporters differed between cohorts, so in each cohort varying components of the overarching hypotheses were evaluated. We found consistent support for the partial hypothesis that parents reported more self-control problems than teachers. Furthermore, the aggregated results indicate most support for the combined hypothesis that children report most problem behaviors, followed by their mothers and fathers, and that teachers report the fewest problems. However, there was considerable inconsistency across cohorts regarding the rank order of children's reports. This article illustrates Bayesian evidence synthesis as a method when some of the cohorts only have data to evaluate a partial hypothesis. With Bayesian evidence synthesis, these cohorts can still contribute to the aggregated results.

Variance constraints strongly influenced model performance in growth mixture modeling: a simulation and empirical study.

BACKGROUND: Growth Mixture Modeling (GMM) is commonly used to group individuals on their development over time, but convergence issues and impossible values are common. This can result in unreliable model estimates. Constraining variance parameters across classes or over time can solve these issues, but can also seriously bias estimates if variances differ. We aimed to determine which variance parameters can best be constrained in Growth Mixture Modeling. METHODS: To identify the variance constraints that lead to the best performance for different sample sizes, we conducted a simulation study and next verified our results with the TRacking Adolescent Individuals' Lives Survey (TRAILS) cohort. RESULTS: If variance parameters differed across classes and over time, fitting a model without constraints led to the best results. No constrained model consistently performed well. However, the model that constrained the random effect variance and residual variances across classes consistently performed very poorly. For a small sample size (N = 100) all models showed issues. In TRAILS, the same model showed substantially different results from the other models and performed poorly in terms of model fit. CONCLUSIONS: If possible, a Growth Mixture Model should be fit without any constraints on variance parameters. If not, we recommend to try different variance specifications and to not solely rely on the default model, which constrains random effect variances and residual variances across classes. The variance structure must always be reported Researchers should carefully follow the GRoLTS-Checklist when analyzing and reporting trajectory analyses.

Unique developmental trajectories of risk behaviors in adolescence and associated outcomes in young adulthood.

This study aimed at assessing developmental trajectories of risk behaviors from adolescence into young adulthood and their associations with outcomes in young adulthood (i.e. education, employment). Data of the TRacking Adolescents' Individual Lives Survey (TRAILS) including 2,149 participants (mean age = 13.6, SD = 0.5, 51% girls) were used to examine the development of alcohol, cannabis, smoking, and externalizing behavior. The results showed that the associations between these risk behaviors varied with age, and revealed varying developmental patterns throughout adolescence. Most notably alcohol use did not covary strongly with the other risk behaviors. The often assumed peak in risk behavior in adolescence was only found in a small group, and only for alcohol (7.4%) and cannabis use (3.4%), but not for smoking or externalizing behavior. Most adolescents revealed only low involvement in risk behavior, with the largest differences between low and high trajectories emerging in late adolescence (> 19 years). Clustering of risk behavior throughout adolescence is rather the exception than the rule and depends on age and type of risk behavior. Differences in risk behavior between individuals become the largest in late adolescence, possibly influencing successful transition into adulthood visible in educational attainment and employment.

Normative, passionate, or problematic? Identification of adolescent gamer subtypes over time.

BACKGROUND AND AIMS: For most youngsters, gaming is a fun and innocent leisure activity. However, some adolescents are prone to develop problematic gaming behavior. It is therefore important to have a comprehensive understanding of psychosocial and game-related characteristics that differentiate highly engaged gamers from problematic gamers. To that end, this study evaluated the stability and consistency of Internet gaming criteria (as suggested by the DSM-5) and psychosocial characteristics in a two-wave longitudinal study including 1928 young adolescents (mean age = 13.3 years, SD = 0.91, 57% boys). METHODS: A confirmatory factor analysis revealed good stability of the Internet gaming disorder (IGD) construct over time. Latent class analyses revealed three classes for boys (recreational, engaged, and problematic) and two classes for girls (recreational and engaged). RESULTS: Significant differences between classes emerged for problem criteria (conflict and problems in social life), gaming duration, impulsivity, social competence, and attention/hyperactivity. The absence of a problematic gaming class for girls suggests that girls are less likely to develop problematic gaming behavior. DISCUSSION: The IGD criteria as proposed by the DSM-5 are a helpful tool to identify problematic gamers, although the results of this study suggest that using a strict cut-off point might result in false positives, particularly for boys. Problem criteria appeared to be the most sensitive and specific in identifying the problematic gamer, whereas escapism criteria were the least specific and sensitive. Careful consideration of the current proposed criteria to identify problematic gaming behavior could benefit the research and clinical field.

Bidirectional effects of Internet-specific parenting practices and compulsive social media and Internet game use.

INTRODUCTION: This two-wave prospective study investigated the bidirectional relation between Internet-specific parenting (reactive restrictions, Internet-specific rules, and frequency and quality of communication about Internet) and adolescents' symptoms of social media disorder (SMD) and Internet gaming disorder (IGD). In addition, we investigated whether this relation was different for boys and girls. METHODS: A sample of 352 adolescents (48.9% boys, Mage = 13.9, SDage = 0.74, range: 11-15) completed questionnaires at two waves. Zero-inflated cross-lagged analyses in Mplus were performed to predict the level of IGD and SMD symptoms by Internet-specific parenting practices and vice versa, while controlling for age, level of education, and outcome at T1. RESULTS: More frequent parent-adolescent communication about Internet predicted more IGD (ß = 0.26, p = .03) and SMD symptoms among boys, and more restrictive rules predicted fewer SMD symptoms among girls (ß = -0.23, p = .08). More IGD symptoms predicted more reactive rules (ß = 0.20, p = .08) among boys and girls and a higher frequency (ß = 0.16, p = .02) and lower quality of communication (ß = -0.24, p < .001) among boys and girls, respectively. CONCLUSIONS: This study demonstrates bidirectional relations between Internet-specific parenting and IGD symptoms, but not SMD symptoms. Displaying IGD symptoms seems to elicit ineffective parental responses, which may further exacerbate problematic involvement in gaming. With respect to problematic social use media among girls, this study suggests that parents should set strict rules regarding Internet use, prior to problematic use of social media. Longitudinal studies on the role of parenting in development of Internet-related disorders would be promising in enhancing our understanding of how parents can effectively prevent problematic involvement in online behaviors among their children.

Training Working Memory in Adolescents Using Serious Game Elements: Pilot Randomized Controlled Trial.

BACKGROUND: Working memory capacity has been found to be impaired in adolescents with various psychological problems, such as addictive behaviors. Training of working memory capacity can lead to significant behavioral improvements, but it is usually long and tedious, taxing participants' motivation to train. OBJECTIVE: This study aimed to evaluate whether adding game elements to the training could help improve adolescents' motivation to train while improving cognition. METHODS: A total of 84 high school students were allocated to a working memory capacity training, a gamified working memory capacity training, or a placebo condition. Working memory capacity, motivation to train, and drinking habits were assessed before and after training. RESULTS: Self-reported evaluations did not show a self-reported preference for the game, but participants in the gamified working memory capacity training condition did train significantly longer. The game successfully increased motivation to train, but this effect faded over time. Working memory capacity increased equally in all conditions but did not lead to significantly lower drinking, which may be due to low drinking levels at baseline. CONCLUSIONS: We recommend that future studies attempt to prolong this motivational effect, as it appeared to fade over time.

Training Behavioral Control in Adolescents Using a Serious Game.

OBJECTIVE: Risk taking, such as heavy alcohol use, is commonplace among adolescents. Nevertheless, prolonged alcohol use at this age can lead to severe health problems. The goal of this study was to develop and evaluate a serious game training ("The Fling"), aimed at increasing behavioral control in adolescents and thereby helping them to improve control over their alcohol use. The game training was compared to a game placebo and a nongame training version in a randomized controlled trial. MATERIALS AND METHODS: A sample of 185 adolescents (mean age 14.9 years) in secondary education participated in the study. They performed four sessions of training, as well as a set of questionnaires and cognitive assessment tasks before and after the training. The basis for the training was the stop-signal paradigm, aimed at increasing behavioral control. RESULTS: The game variants were shown to motivate adolescents beyond the level of the nongame version. Behavioral control improved significantly over time, but this effect was also present in the game placebo, suggesting that the game activities alone may have had a beneficial effect on our measures of behavioral control. As baseline drinking levels were low, no significant training effects on drinking behavior were found. CONCLUSIONS: Although the current results are not yet conclusive as to whether "The Fling" is effective as a cognitive training, they do warrant further research in this direction. This study also shows that serious games may be uniquely suitable to bridge the gap between an evidence-based training paradigm and an attractive, motivating training environment.