Effects of individual differences, society, and culture on youth-rated problems and strengths in 38 societies.

BACKGROUND: Clinicians increasingly serve youths from societal/cultural backgrounds different from their own. This raises questions about how to interpret what such youths report. Rescorla et al. (2019, European Child & Adolescent Psychiatry, 28, 1107) found that much more variance in 72,493 parents' ratings of their offspring's mental health problems was accounted for by individual differences than by societal or cultural differences. Although parents' reports are essential for clinical assessment of their offspring, they reflect parents' perceptions of the offspring. Consequently, clinical assessment also requires self-reports from the offspring themselves. To test effects of individual differences, society, and culture on youths' self-ratings of their problems and strengths, we analyzed Youth Self-Report (YSR) scores for 39,849 11-17 year olds in 38 societies. METHODS: Indigenous researchers obtained YSR self-ratings from population samples of youths in 38 societies representing 10 culture cluster identified in the Global Leadership and Organizational Behavioral Effectiveness study. Hierarchical linear modeling of scores on 17 problem scales and one strengths scale estimated the percent of variance accounted for by individual differences (including measurement error), society, and culture cluster. ANOVAs tested age and gender effects. RESULTS: Averaged across the 17 problem scales, individual differences accounted for 92.5% of variance, societal differences 6.0%, and cultural differences 1.5%. For strengths, individual differences accounted for 83.4% of variance, societal differences 10.1%, and cultural differences 6.5%. Age and gender had very small effects. CONCLUSIONS: Like parents' ratings, youths' self-ratings of problems were affected much more by individual differences than societal/cultural differences. Most variance in self-rated strengths also reflected individual differences, but societal/cultural effects were larger than for problems, suggesting greater influence of social desirability. The clinical significance of individual differences in youths' self-reports should thus not be minimized by societal/cultural differences, which-while important-can be taken into account with appropriate norms, as can gender and age differences.

Testing Syndromes of Psychopathology in Parent and Youth Ratings Across Societies.

As societies become increasingly diverse, mental health professionals need instruments for assessing emotional, behavioral, and social problems in terms of constructs that are supported within and across societies. Building on decades of research findings, multisample alignment confirmatory factor analyses tested an empirically based 8-syndrome model on parent ratings across 30 societies and youth self-ratings across 19 societies. The Child Behavior Checklist for Ages 6-18 and Youth Self-Report for Ages 11-18 were used to measure syndromes descriptively designated as Anxious/Depressed, Withdrawn/Depressed, Somatic Complaints, Social Problems, Thought Problems, Attention Problems, Rule-Breaking Behavior, and Aggressive Behavior. For both parent ratings (N = 61,703) and self-ratings (N = 29,486), results supported aggregation of problem items into 8 first-order syndromes for all societies (configural invariance), plus the invariance of item loadings (metric invariance) across the majority of societies. Supported across many societies in both parent and self-ratings, the 8 syndromes offer a parsimonious phenotypic taxonomy with clearly operationalized assessment criteria. Mental health professionals in many societies can use the 8 syndromes to assess children and youths for clinical, training, and scientific purposes.

Relationship between particular areas of victimization and mental health in the context of multiple victimizations in Spanish adolescents.

The main objective of this paper is to study the relationship between different areas of victimization (e.g., sexual victimization) and psychological symptoms taking into account the full range of victimizations adolescents suffer. The final aim is to contribute further evidence regarding the bias that those studies which focus on just one area of victimization may be introducing into our psychological knowledge. A total of 923 adolescents (62.4% girls) between 14 and 18 years old were recruited from seven secondary schools in Catalonia, Spain. The Youth Self-report and the Juvenile Victimization Questionnaire were employed to assess psychological problems (internalizing and externalizing symptoms) and victimization, respectively. The large majority of adolescents reported having experienced more than one area of victimization. However, Conventional Crime area was the one that was more reported in isolation. Overall, the explicative power of a particular area of victimization was greatly reduced or even lost its significance when the other areas were taken into account. However, some areas remained significant and were different by gender. Clinicians and researchers should take into account the whole range of victimizations adolescents suffer when intending to understand the psychological aftermaths of victimization. Some areas of victimization appear to be more important at explaining particular psychological symptoms, those being Peer and Sibling Victimization in the case of boys, and both Conventional Crime and Internet Victimization in the case of girls.

Prevalence and severity of categorical and dimensional personality disorders in adolescents with eating disorders.

OBJECTIVE: The objective of this study is to explore and compare the prevalence of categorical and dimensional personality disorders (PDs) and their severity in Spanish adolescents with Eating Disorders (EDs). METHOD: Diagnostic and Statistical Manual of Mental Disorders Fourth Edition and International Classification of Diseases, Tenth Revision-10 modules of the International Personality Disorder Examination were administered to a sample of 100 female adolescents with EDs (mean age=15.8 years, SD=0.9). RESULTS: 'Thirty-three per cent of the sample had at least one PD, in most cases a simple PD. The rate of PDs was 64-76% in bulimia patients, 22-28% in anorexia and 25% in EDs not otherwise specified. The highest dimensional scores were observed in bulimia, [corrected] mainly in borderline and histrionic PDs, and higher scores for anankastic PD in anorexia than in the other ED diagnoses. Overall, purging type EDs had higher cluster B personality pathology scores than restrictive type.' [corrected] The Publisher would like to apologize for this error and any confusion it may have caused. [corrected]. DISCUSSION: Adolescent female patients with ED have a risk of presenting a comorbid PD, especially patients with bulimia and purging type EDs.

Usefulness of the International Personality Disorder Examination Screening Questionnaire for borderline and impulsive personality pathology in adolescents.

UNLABELLED: The aim of this study was to analyze the usefulness of the International Personality Disorder Examination Screening Questionnaire (IPDE-SQ) for identifying DSM-IV and ICD-10 Borderline and Impulsive personality disorders (PD) in Spanish adolescents. METHOD: The DSM-IV and ICD-10 IPDE-SQ screeners were used and compared with the diagnoses obtained with the IPDE semistructured interview in a sample of 125 adolescents treated in a psychiatric department. RESULTS: For primary screening, the cutoff point with the best combination of sensitivity and specificity for ICD-10 impulsive and borderline PDs was obtained with three positive items, whereas for DSM-IV borderline the best PD cut-off was five positive items. For secondary screening, the best option would be one item above the cut-off points proposed for primary screening. CONCLUSION: The 3-item cut-off point in the IPDE-SQ produces a high proportion of false positives on impulsive and borderline PDs in clinical adolescents. We propose several cut-off points, depending on whether the study is designed to perform primary or secondary screening.

Polyvictimization and risk for suicidal phenomena in a community sample of Spanish adolescents.

This study aims to provide data regarding the association between reported degree of victimization and suicidal phenomena, with special emphasis on gender differences. There were 923 adolescents recruited from eight secondary schools in Catalonia, Spain. The Youth Self-Report (YSR) and the Juvenile Victimization Questionnaire (JVQ) were used to assess suicidal phenomena and victimization, respectively. Participants were divided into three groups (nonvictim, victim, and polyvictim groups) according to the total number of different kinds of victimization reported. Results showed that the polyvictim group reported significantly more suicidal phenomena than did the victim and nonvictim groups in both boys and girls. Furthermore, although no gender differences in reported suicidal phenomena were found in the nonvictim group, girls reported significantly more suicidal phenomena in both the victim and the polyvictim groups. In conclusion, the results suggest that victimization may play an important role in generating gender differences with respect to reported suicidal phenomena. In addition, this study highlights the importance of taking into account the whole range of victimizations suffered by adolescents when seeking to design suicide prevention and intervention policies.

Factor structure of the adolescent coping orientation for problem experiences in Spanish adolescents.

The present study aimed to identify the best structure of the Adolescent Coping Orientation for Problem Experiences when applied to Spanish adolescents. A confirmatory factor analysis of five previous factor structures was conducted. As the data did not fit previous factor models, two exploratory factor analyses (first- and second-order) were carried out to identify the structure for Spanish adolescents and to analyse its criterion validity in relation to mental health, which was assessed by means of the Youth Self-Report. A first-wave sample of 1,152 secondary education pupils (645 boys, 56%; 507 girls, 44%; M age = 14.4 yr., SD = 1.4) was involved in the confirmatory and exploratory factor analyses. A second-wave sample of = 374 secondary education pupils (188 boys, 50.5%; 186 girls, 49.5%; M age = 15.4 yr., SD = 1.1) was used to assess criterion validity. The results yielded eight first-order factors with Cronbach's alpha ranging from .63 to .79, and two second-order factors that replicated the Approach and Avoidance focus of coping. The paper discusses both the content of the extracted factors and mental health issues.

The influence of personality disorders on the use of mental health services in adolescents with psychiatric disorders.

OBJECTIVE: The aims of this study were to explore the influence of personality disorders (PDs) in Spanish adolescents with Axis I psychiatric disorders on their use of mental health services and to analyze the risk of having a comorbid PD in relation to psychiatric service use. METHODS: The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and International Classification of Diseases, Tenth Revision (ICD-10) modules of the semistructured interview International Personality Disorders Examination were administered to a sample of 112 adolescent psychiatric patients (mean age = 15.8 years; SD, 0.8; range, 15-17; 79% women) at the point of initiating treatment. On the basis of the interview, subjects were divided into two groups: a PD group (PDG) and a non-PD group (NPDG). After 3 years of treatment, clinical records were retrospectively analyzed. RESULTS: The PDG showed a significantly higher number of psychiatric admissions (P < .001), days per psychiatric admission (P < .001), and psychiatric emergencies (P < .010) than the NPDG, although the number of outpatient consultations was not significantly higher. Logistic regression analysis showed that the probability of belonging to the PDG rather than the NPDG increased with each psychiatric admission (odds ratio [OR] = 1.67 for DSM-IV criteria and OR = 1.59 for ICD-10 criteria), after controlling by sex, age, and comorbidity (Axis I disorders). CONCLUSIONS: Patients with comorbid PD used more inpatient and emergency psychiatric services than did patients without a PD. Large number of psychiatric hospitalizations suggests the likelihood of a PD being present.

Effects of poly-victimization on self-esteem and post-traumatic stress symptoms in Spanish adolescents.

This study aims to provide evidence concerning the effects of experiencing multiple forms of victimization (poly-victimization) on self-esteem and post-traumatic stress symptoms in Spanish adolescents. A total of 722 adolescents were recruited from seven secondary schools in Catalonia, Spain. The Rosenberg Self-Esteem Scale, the Youth Self Report and the Juvenile Victimization Questionnaire were employed to assess self-esteem, post-traumatic stress symptoms and victimization, respectively. Participants were divided into three groups (non-victim, victim and poly-victim groups) according to the total number of different kinds of victimization experienced. Results showed that 88.4 % of adolescents had been exposed to at least one kind of victimization. Poly-victimization was associated with a higher number of post-traumatic stress symptoms in both boys and girls. Also, self-liking was significantly lower in the poly-victim group, whereas self-competence was equivalent across the three victimization groups. Girls were approximately twice as likely to report child maltreatment (OR = 1.92) and sexual victimization (OR = 2.41) as boys. In conclusion, the present study adds evidence on the importance of taking account of the full burden of victimizations suffered when studying victimization correlates. Also, it highlights the importance of prevention policies to focus particularly on preserving adolescents' sense of social worth.

Subtypes of adolescents with substance use disorders and psychiatric comorbidity using cluster and discriminant analysis of MMPI-A profiles.

The main aim of this study was to replicate and extend previous results on subtypes of adolescents with substance use disorders (SUD), according to their Minnesota Multiphasic Personality Inventory for adolescents (MMPI-A) profiles. Sixty patients with SUD and psychiatric comorbidity (41.7% male, mean age = 15.9 years old) completed the MMPI-A, the Teen Addiction Severity Index (T-ASI), the Child Behaviour Checklist (CBCL), and were interviewed in order to determine DSMIV diagnoses and level of substance use. Mean MMPI-A personality profile showed moderate peaks in Psychopathic Deviate, Depression and Hysteria scales. Hierarchical cluster analysis revealed four profiles (acting-out, 35% of the sample; disorganized-conflictive, 15%; normative-impulsive, 15%; and deceptive-concealed, 35%). External correlates were found between cluster 1, CBCL externalizing symptoms at a clinical level and conduct disorders, and between cluster 2 and mixed CBCL internalized/externalized symptoms at a clinical level. Discriminant analysis showed that Depression, Psychopathic Deviate and Psychasthenia MMPI-A scales correctly classified 90% of the patients into the clusters obtained.

Training referential communicative skills to individuals with autism spectrum disorder: a pilot study.

The present study reports the effects of referential communication training in individuals formally diagnosed with autism spectrum disorder (ASD). Participants were 20 children with ASD (M age = 14.3 yr., SD = 4.2; 6 girls, 14 boys) in the role of speakers and 20 control children, who acted as listeners. They were all enrolled in mainstream compulsory education. Inclusion/exclusion criteria were defined according to the clinical diagnosis of ASD, the presence or absence of additional or associated disability, previous training in referential communication, and any drug treatment. Speakers were randomly assigned to one of two groups (trained vs untrained). Linguistic age, cognitive level and autistic symptoms were analyzed, respectively, with the Peabody Picture Vocabulary Test (PPVT), the Wechsler Intelligence Scale (WISC-R or WAIS-III), and the Autistic Behavior Checklist (ABC). Communicative abilities were analyzed through two indexes related to message complexity and self-regulation. The trained group was trained in referential communication tasks (task analysis, role taking, and task evaluation), while the untrained group took part in a communicative game but without any specific communicative training. The results showed that the complexity of emitted messages had improved statistically significantly in the trained group as an effect of training. Ecological referential communication is shown to be an appropriate paradigm for studying the communicative process and its products and could be used to develop and implement a training program focused on those skills in which individuals with ASD are most deficient.

Self-harm behavior and suicidal ideation among high school students. Gender differences and relationship with coping strategies.

Deliberate self-harm, suicide intents and suicidal ideation are suicide risk symptoms in adolescence. The knowledge of their prevalence and associated characteristics is needed to prevent and treat them properly. The aims of the present study are: a) to analyse the presence of deliberate self-harm and suicidal ideation among a general adolescent population according to sex, b) to investigate the link between these two symptoms, calculating the risk ratio (RR) of self-harming behavior among adolescents with suicidal ideation, and c) to analyze the coping strategies used by adolescents with presence/absence of these behaviors. Participants are 1,171 Catalonian high school students (518 boys and 653 girls) aged 12 to 16 years. Self-harm behavior was assessed by means of YSR and coping strategies by means of CRI-Youth. Results indicate that the prevalence of self-harm behavior is 11.4% and the one for the suicidal ideation is 12.5%, percentages that are in accordance with the literature. No gender differences are found, but there is an increase with age in both types of risk behaviors. There is a significant link between deliberate self-harm and suicidal ideation. The RR indicates that the self-harming behavior is 10 times more likely to occur in the adolescents with suicidal ideation than in the adolescents without such ideation. The use of specific coping strategies differentiates between adolescents with presence/absence of these risk behaviors, especially in the case of girls. These findings may have important preventive value and contribute to the implementation of more effective treatments. Key words: Self-harm behavior, suicidal ideation, coping strategies, adolescence, sex differences.

Psychometric properties of the Coping Response Inventory with Brazilian adolescents.

To analyze the psychometric properties of the Coping Response Inventory-Youth Form (CRI-Y) and its applicability, 426 Brazilian adolescents (43.3% boys, 56.7% girls), ages 12 to 18 years (M = 16.5, SD = 1.6), completed the authorized Brazilian/Portuguese version of the 1993 original. Analysis showed higher use of Approach coping and Emotional Discharge by the girls. The inventory showed internal consistency reliability was similar to that of the original scale. A two-factor structure reflecting Approach and Avoidance coping was found; however, the distribution of loadings of specific coping scales on this two-factor structure did not fit the original Moos model. The criterion validity analyzed by the use of the Youth Self-Report showed significant positive relation between the Avoidance dimension and Psychopathological symptoms for boys and girls. Data were discussed with respect to coping theory, assessment, and cultural influences.

Multilevel approach to stressors, coping, and psychopathological symptoms.

A 4-yr. longitudinal study was conducted of the relationship between stressors, coping strategies, and psychopathological symptoms in a group of 447 adolescents. The Coping Responses Inventory-Youth Form and the Youth Self-Report were used to evaluate coping strategies and psychopathological symptoms, respectively. Stressors were identified on the basis of written reports produced by the adolescents and coded using the System of Coding Problems of Adolescents. A multilevel approach showed that scores for externalizing symptoms increased significantly with age. General distress and internalization also tended to increase with age, although without reaching statistical significance. Approach and avoidance coping strategies remain stable across the ages studied. Avoidant coping increases psychopathological symptoms, whereas the influence of approach coping depends on the type of stressor (personal, interpersonal, or nonpersonal).

Stability and consistency of coping in adolescence: A longitudinal study.

This study analyzed stability and consistency of coping among adolescents. The objectives were twofold: a) to analyze temporal stability and cross-situational consistency of coping responses after a 17- month interval, taking into account gender, age and type of stressor. b) To analyze the relative weight of contextual versus dispositional factors in predicting future coping. A cohort of 341 adolescents (51% girls and 49% boys aged between 12 and 16) were assessed twice by means of the Coping Responses Inventory - Youth. The results indicated that the coping responses were quite stable over time at the group level, but with important within-subject differences. Girls showed slightly more stability than boys. Among the girls, Avoidance coping showed as much stability as consistency and Approach coping showed more stability than consistency. Among the boys, Avoidance coping showed more stability than consistency, and Approach coping showed both low stability and low consistency. Among the boys, the coping used at Time 1 barely predicted that used at Time 2; in contrast, among the girls, the type of coping used in the past, especially Avoidance coping, predicted the coping that would be used in the future.

Facing Interpersonal Violence: Identifying the Coping Profile of Poly-Victimized Resilient Adolescents.

Coping strategies are factors that mediate the relationship between interpersonal victimizations and psychological maladjustment. The objectives are as follows: (a) to establish the coping profile of adolescents according to the number of reported interpersonal victimizations; (b) to identify the most victimized adolescents (poly-victims), detecting those with psychological symptoms (nonresilient poly-victims) and those without psychological symptoms (resilient poly-victims), and then to examine any differences in coping strategies between the two groups; (c) to determine the accumulative effect of victimizations on mental health; and (d) to test the mediating role of both approach and avoidance coping between lifetime interpersonal victimizations and symptoms. Participants were 918 community Spanish adolescents (62.7% girls) aged between 14 and 18 years. Measures used were Youth Self-Report, Juvenile Victimization Questionnaire, and Adolescent Coping Orientation for Problem Experiences. The following results were reported: (a) The most victimized adolescents used to a greater degree avoidance coping strategies than nonvictimized adolescents. (b) Resilient poly-victimized adolescents were more likely to seek family support and tended to use more positive reappraisal than nonresilient poly-victimized adolescents. (c) A clear cumulative effect of victimizations on mental health was observed: 45% of the most victimized adolescents (poly-victims) reached clinical range on Youth Self-Report in front of 2% of nonvictimized adolescents. (d) Avoidance coping and more specifically Escaping and Venting feelings strategies played a mediating role between interpersonal victimizations and psychological symptoms. Approach coping had no mediating role, except for Positive reappraisal in girls. In conclusion, the possibility of identifying the coping profile of victimized adolescents may have clinical implications in terms of both prevention and intervention.

Identifying the risk of deliberate self-harm among young prisoners by means of coping typologies.

Self-harming behavior during incarceration has been a topic of increasing attention in recent years. Some authors attribute these episodes to the high level of stress that imprisonment generates coupled with a low quality of coping strategies employed by inmates. The main aim of this study was to identify, by means of coping typologies, prisoners at higher risk of self-harming behavior. The results highlighted the fact that coping typologies permitted the classification of inmates into four groups and the identification of those at lower and higher risk of self-harming. The group at greater risk was the one that used more avoidance and less approach coping.

Personality and coping in young inmates: a cluster typology.

OBJECTIVE: Firstly, to identify groups of inmates according to personality. Secondly, to differentiate types of personality through coping strategies, psychopathology, criminal records and social factors. METHOD: A cross-sectional design was used to study psychosocial, correctional, personality and clinical characteristics in inmates. The group was composed of 106 male inmates. The measures used to evaluate personality, clinical and psychosocial variables were a standard protocol and three self-report questionnaires: the Millon Clinical Multiaxial Inventory-II, the Minnesota Multiphasic Personality Inventory-2 and the Coping Responses Inventory-Adult Form. A cluster analysis, ANOVA and Kruskall-Wallis test were conducted. RESULTS: Four clusters were identified. The secondary type was characterized by an impulsive, suspicious, hostile personality, by anxiety, a low tolerance of frustration, and by the use of cognitive avoidance coping. The controlled-healthy type showed a less pathological and more self-controlled personality. The primarytype was similar to secondary, but with lower tendency to impulsivity. The inhibited-affected type was shown to have an avoidant personality, greater tendency to symptomatology and also to use acceptance-resignation and emotional discharge coping. CONCLUSION: The four groups of young inmates identified showed profiles with different degrees of psychopathological risk and also different coping profiles.

Personality profile for adolescents at risk for internalizing and externalizing problems.

To estimate the personality profile for adolescents at psychopathological risk, a community sample of 762 adolescents, ages 12 to 16 years (M = 13.8, SD = 1.3), 53% boys and 47% girls, from the city of Barcelona, Spain, were tested with the Youth Self-Report and the High School Personality Questionnaire. Among this group, 140 adolescents were identified as showing symptoms of psychopathological risk for internalizing or externalizing syndromes as defined by Achenbach's theory. Analysis indicated that adolescents who scored high for internalizing and externalizing symptoms showed differing personality profiles, which also differed by sex. Boys scoring high on internalizing tended to adopt an inhibited, shy, and apprehensive behavior, while girls showed a tendency to display a more distant and cold affect and changeable emotionality. The personality pattern of boys and girls who scored high on externalizing symptoms showed both similar and different aspects. Both sexes displayed characteristics such as dominance, poor rule conformity, and low self-discipline. However, girls who scored high on externalizing symptoms also tended to show impulsiveness, social boldness, and low sensitivity.

Psychometric properties and dimensional structure of the Spanish version of the Coping Responses Inventory-Adult Form.

One of the goals of psychological assessment focuses on the adaptation of its instruments to different populations. The objective of this study is to establish the psychometric properties and dimensional structure of the Spanish version of the Coping Responses Inventory-Adult Form (CRI-Adult, Moos, 1993). The following criteria were analyzed: a) descriptive statistics; b) internal consistency reliability (Cronbach's alpha, and intercorrelations between scales); c) test-retest reliability (4-week interval); d) dimensionality of CRI-Adult (exploratory factor analysis); e) construct validity (confirmatory factor analysis); f) convergent criterion validity (correlations between CRI-Adult and Coping Strategies Indicator, CSI, Amirkhan, 1990), and g) predictive criterion validity (correlations between CRI-Adult, and SCL-90-R, Derogatis, 1983). The results, obtained with 800 adults from Barcelona and surrounding area (334 men and 466 women, aged between 18 to 76 years) indicate that the Spanish version of CRI-Adult has satisfactory psychometric properties that allow using this test with guarantee.