Identifying Subgroups of Youth Suicide Decedents Based on Clinical Profiles of Psychiatric and Medical Diagnoses: A Latent Class Analysis.

PURPOSE: To identify risk subgroups of youth suicide decedents using demographic and clinical psychiatric and medical diagnostic profiles to inform tailored youth suicide prevention efforts. METHODS: This study linked Ohio Medicaid and death certificate data for Medicaid enrolled youth aged 8-25 years who died by suicide between January 1, 2010, and December 31, 2020 (N = 511). Latent class analysis was used to identify distinct clinical risk subgroups. RESULTS: Three latent classes were identified. Internalizing problems were common across all classes, but especially prevalent in class 1, the High Internalizing + Multiple Comorbidities group (n = 152, 30%). A prior history of suicidal behavior was confined to class 1 decedents, who were otherwise characterized by substance misuse, and multiple psychiatric and medical comorbidities. Class 2 decedents, the Internalizing + Externalizing group (n = 176, 34%), were more often younger, male, Black, and unlikely to have a history of substance misuse. Decedents in class 3, the Internalizing + Substance Misuse group (n = 183, 36%), were more often older and likely to have a history of substance misuse, but unlikely to exhibit other externalizing problems. DISCUSSION: Internalizing psychopathology is particularly common among youth who die by suicide, with comorbid externalizing psychopathology, substance misuse, and medical problems contributing to youth suicide risk. Because less than a third of youth who die by suicide have a prior history of recognized suicidal thinking or behavior, universal screening for youth suicide risk should be considered, particularly in younger children, and efforts to integrate suicide prevention in traditional health care settings should be prioritized.

Principles, policies, and practices: Thoughts on their integration over the rise of the developmental psychopathology perspective and into the future.

Developmental psychopathology has, since the late 20th century, offered an influential integrative framework for conceptualizing psychological health, distress, and dysfunction across the lifespan. Leaders in the field have periodically generated predictions about its future and have proposed ways to increase the macroparadigm's impact. In this paper, we examine, using articles sampled from each decade of the journal Development and Psychopathology's existence as a rough guide, the degree to which the themes that earlier predictions have emphasized have come to fruition and the ways in which the field might further capitalize on the strengths of this approach to advance knowledge and practice in psychology. We focus in particular on two key themes first, we explore the degree to which researchers have capitalized on the framework's capacity for principled flexibility to generate novel work that integrates neurobiological and/or social-contextual factors measured at multiple levels and offer ideas for moving this kind of work forward. Second, we discuss how extensively articles have emphasized implications for intervention or prevention and how the field might amplify the voice of developmental psychopathology in applied settings.

Maternal depression and child telomere length: The role of genetic sensitivity.

BACKGROUND: The stress of a mother's depression may increasingly tax psychobiological systems that help children with self-regulation, increasing children's allostatic load over time. Some evidence supports children exposed to maternal depression tend to have shorter telomeres and tend to have more somatic and psychological problems. Children having one or more A1 alleles of dopamine receptor 2 (DRD2, rs1800497), tend to have greater sensitivity to maternal depression and could experience more adverse child outcomes that contribute to greater allostatic load. METHODS: Using the Future Families and Child Wellbeing dataset, secondary-data analyses were used to test the effect of repeated exposure to maternal depression during early childhood on children's telomere length during middle childhood moderated by children's DRD2 genotype (N = 2884). RESULTS: Greater maternal depression was not significantly associated with shorter child telomere length and this association was not moderated by DRD2 genotypes while controlling for factors associated with child telomere length. IMPLICATIONS: The effect of maternal depression on children's TL may not be significant in populations from diverse racial-ethnic and family backgrounds during middle childhood. These findings could help further our current understanding psychobiological systems affected by maternal depression that result in adverse child outcomes. LIMITATIONS: Even though this study used a relatively large and diverse sample, replication of DRD2 moderation in even larger samples is an important next step.

Cross-lagged effects between parent depression and child internalizing problems.

The bidirectional associations between maternal depression and child psychological functioning are generally well-established. Paternal depression may also share some bidirectional associations with child psychological functioning, but there is limited research in this area. It is unclear how or when one family member's anxiety or depression might affect another family member's mental health. The present study tested the bidirectional associations between maternal depression, paternal depression, and children's internalizing problems of anxiety and depression from early childhood into mid-adolescence. The present study also included unmarried parents, who are often underrepresented in research. Secondary analyses were performed using a subset of data from the Fragile Families and Child Wellbeing (FFCW) study, beginning when children were 3-years-old and ending when children were 15-years-old. Families (N = 4,873) were from racially and economically diverse backgrounds-nearly half of the mothers were non-Hispanic Black and 65% of mothers had a high school degree or further education. We found evidence of bidirectional associations between maternal depression and child internalizing problems across early childhood and into adolescence. We found no bidirectional associations between paternal and maternal depression or between paternal depression and children's internalizing problems. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The structure of aggression in conflict-prone couples: Validation of a measure of the Forms and Functions of Intimate Partner Aggression (FFIPA).

Intimate partner aggression (IPA) is a complex construct composed of the means and the motivations by which a person harms his or her intimate partner. Existing measures only assess forms of IPA perpetration while neglecting to measure the motivations for aggressing. The present study sought to fill this lacuna by adapting and validating an existing measure of the forms and functions of adolescent peer aggression to assess IPA perpetration in adults. This new measure-the Forms and Functions of Intimate Partner Aggression (FFIPA)-comprises 4 latent dimensions of IPA (i.e., overt, relational, proactive, and reactive). Participants were 341 heavy-drinking heterosexual couples (N = 682) with a recent history of psychological and/or physical IPA recruited from 2 metropolitan cities in the United States. The FFIPA demonstrated good model fit and internal validity. Unique patterns of convergent and criterion-related validity supported the 4 dimensions of the FFIPA. Results also indicated women perpetrated significantly more overt and relational aggression than men. Findings support the FFIPA as a valid measure of the forms and functions of IPA perpetration. More important, as the only instrument that parses the forms and functions of IPA perpetration, the FFIPA delineates the unique motivations of an aggressive partner separately from the form of his or her aggressive behavior(s). Further replication is needed to generalize this measure to nonconflictual and other types of intimate relationships. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Longitudinal Relationships Between Parent Factors, Children's Bullying, and Victimization Behaviors.

Longitudinal data from NICHD Study of Early Child Care and Youth Development tested direct, indirect and reciprocal effects of maternal depressive symptoms, stress/support factors on child bullying and peer victimization through mother-child relationship quality at grades 3, 5, 6. Data from 828 mother-child dyads indicated small significant effects of some hypothesized pathways, including a small direct effect of maternal depressive symptoms at grade 3 on peer victimization at grade 5, but not on bullying behaviors. Mother-child relationship quality at grade 5 negatively predicted bullying at grade 6, but not peer victimization. There were small effects of bullying behaviors at grade 5 on decreased mother-child relationship quality at grade 6. Maternal employment at grade 3 predicted decreased bullying behaviors at grade 6 through mother-child relationship quality at grade 5. Findings are relevant for parent inclusive research and approaches to anti-bully intervention strategies and prevention policies.

Role of adolescent exposure to rockets in the links between personality vulnerability and psychopathology.

The aim of this study is to examine the role of repeated exposure to rocket attacks in the links between personality vulnerability (dependency and self-criticism) and internalizing/externalizing psychopathology. A main-effect vulnerability model (personality leads to psychopathology) was compared with a main-effect scarring model (psychopathology leads to personality vulnerability). Also, a stress-diathesis pattern (personality vulnerability is activated under stress) was compared to a dual-vulnerability pattern (either personality vulnerability or stress, but not both, lead to psychopathology). Israeli adolescents (N = 362) repeatedly exposed to rocket attacks were assessed annually over 3 years. In 2008 and 2010, personality and psychopathology were assessed. Cumulative exposure was measured as the sums of exposure across the three assessment waves. Theoretical models were tested via Autoregressive Cross-Lagged Structural Equation Modeling analyses. Baseline dependency and self-criticism were associated with an increase in anxiety, whereas baseline depression was associated with an increase in dependency. Under low, not high, levels of rocket exposure, self-criticism and depression were longitudinally associated. Violence commission was associated with an increase in dependency under high, not low, cumulative exposure. Results are consistent with both scarring and vulnerability models, and with both stress-diathesis and dual-vulnerability patterns of adolescent risk and resilience.

Roles of positive psychological outcomes in future health perception and mental health problems: A report from the Childhood Cancer Survivor Study.

OBJECTIVE: Positive psychological outcomes among adolescent and young adult survivors of childhood cancer may influence long-term health status. We examined posttraumatic growth (PTG) and Life satisfaction (LS) in adolescence, and their impact on future emotional and physical health status in young adulthood. METHODS: Survivors (n = 2802) from the Childhood Cancer Survivor Study were longitudinally analyzed across social, emotional, and physical factors during adolescence (12-17 years old), and PTG (PTG-Inventory) and LS (Cantril-Ladder-of-Life) during young adulthood (19-24 years old). The impact of PTG and LS on survivors' future long-term mental health, physical health, and social skills was also examined (23-28 years old) using Structural Equation Modeling. RESULTS: Survivors reported high levels of LS (M = 7.43, range 1 to 10) and a positive impact from their cancer experience (M = 48.78, range 0 to 105). Adolescent predictors of higher PTG included older age at diagnosis (p = 0.001), experiencing more severe chronic health conditions (p = 0.01), cancer recurrence/relapse (p = 0.01), and being diagnosed with a non-CNS cancer (p = 0.001). Higher perceived general health (p = 0.01), higher social skills (p = 0.001), and diagnosis with a non-CNS cancer (p = 0.02) were associated with higher LS. Higher PTG during young adulthood predicted poorer perceived health (p = 0.04) and worse emotional health (p = 0.001) in later adulthood. Higher LS predicted better emotional health (p = 0.001) and better perceived health (p = 0.001). CONCLUSIONS: While LS was found to help survivors have better perceived long-term emotional and physical health outcomes, survivors with higher PTG fond both positive and negative impacts from cancer. Future therapeutic trials to improve LS should be considered.

Perceived family social support buffers against the effects of exposure to rocket attacks on adolescent depression, aggression, and severe violence.

The authors compared the protective effects of 3 sources of perceived social support-from family members, friends, and school personnel-on internalizing and externalizing symptoms in adolescents exposed to rocket attacks. Data were based on 362 Israeli adolescents (median age = 14), chronically exposed to rockets from the Gaza Strip, for whom robust effects of exposure on internalizing and externalizing symptoms were reported during the 2009-2010 period (Henrich & Shahar, 2013). New analyses revealed that perceived family social support assessed in 2009 buffered against the effect of exposure to rocket attacks on depression, aggression, and severe violence during 2009-2010. Findings are consistent with a human-ecological perspective exposure to political violence and encourage the employment of family-based preventive interventions in afflicted areas.

Depressive symptoms, anxiety and academic motivation in youth: Do schools and families make a difference?

This longitudinal study aimed to examine the association between depressive and anxiety symptoms and academic motivation by gender, and whether positive school and family factors would be associated with academic motivation, in spite of the presence of such symptoms. Study participants were predominantly economically disadvantaged youths aged 13-15 years in a Northeastern US urban public school system. The Social and Health Assessment (SAHA) served as the basis for a survey undertaken in 2003 and 2004 with information being used from students who participated at both time points (N = 643). Multiple linear regression analyses showed that depressive symptoms were negatively associated with academic motivation, while anxiety was positively related to academic motivation in both genders. Teacher support, school attachment and parental control were positively related to academic motivation even in the presence of internalizing problems. The negative association of depressive symptoms with academic motivation may be potentially decreased by attachment to school.

The role of emotion perception in adaptive functioning of people with autism spectrum disorders.

Cognitive functioning has historically been used to predict adaptive outcomes of people with autism spectrum disorders; however, research shows that it is not a complete predictor. The current study explored whether emotion perception was a predictor of adaptive outcomes, and more specifically, hypothesized that emotion perception (Diagnostic Analysis of Nonverbal Accuracy-2 error scores) would mediate adaptive functioning of people with autism spectrum disorder (Vineland Adaptive Behavior Scales, Second Edition). People with autism spectrum disorders demonstrated significantly lower adaptive functioning and emotion perception skills compared to typically developing individuals. Emotion perception acted as a significant mediator for socialization, but not communication or daily living skills, highlighting that in people with autism spectrum disorders, lower socialization abilities is the result, in part, of emotion perception deficits. It was unexpected that emotion perception was not a mediator for communication skills. This may be related to sample restrictions, or the narrow focus on emotion perception. Future research should involve a larger, more inclusive autism spectrum disorder sample, broaden approaches to exploring relationships between social perception and adaptive outcomes, and relate findings to brain mechanisms underlying emotion perception.

Moderators of the effect of peer victimization during fifth grade on subsequent symptoms of (anxious) depression: the roles of engagement in bullying and baseline symptomatology.

Two hypothesized moderators of the effect of peer victimization during fifth grade on subsequent symptoms of (anxious) depression in sixth grade were examined: engagement in bullying and baseline fifth grade symptoms of (anxious) depression. Analyses were conducted on longitudinal data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Interview data from 1,081 fifth grade participants assessed peer victimization and engagement in bullying classmates during the school year. Self-reported symptoms of depression were measured in fifth and sixth grade with the Child Depression Inventory Short form. Additionally, maternal reports of child anxious depression were measured with the Child Behavior Checklist. Engagement in bullying and concurrent depression symptoms moderated the effect of peer victimization in fifth grade on child-reported symptoms of depression in sixth grade. The adverse effect of peer victimization was stronger for children with high levels of concurrent depression symptoms or engagement in bullying. Concurrent symptomatology also moderated the effects of peer victimization on mother-reported child anxious depression 1 year later.

Psychological interventions helping pediatric oncology patients cope with medical procedures: a nurse-centered approach.

PURPOSE OF THE RESEARCH: This study explored whether psychological interventions are currently used by pediatric oncology nurses to help children cope with their treatment and, if so, which interventions were considered by oncology nurses to be the most effective. METHODS AND SAMPLE: A web-based survey was developed to assess pediatric oncology nurses' impressions of psychological care for pediatric patients during their medical treatment. A sample of 88 pediatric oncologic nurses from twelve leading pediatric oncology departments in the US participated in the survey. The closed questions were analyzed through quantitative methods with statistics. The open questions were examined through qualitative methods with report narratives and discourse analysis. KEY RESULTS: Pediatric oncology nurses identified three psychological interventions to reduce suffering: educating children by explaining the procedure; providing emotional support to children by listening, answering children's worries, or holding their hands; and distracting children through passive and active forms. The survey further showed that nurses spent on average 3 h per day providing emotional support, would be willing to be trained in additional interventions (93%), and could devote at least 10 min per treatment to provide support (77%). CONCLUSIONS: This work demonstrates the central role nurses play as emotional support caregivers. Since nurses would be willing to provide emotional support during treatments, training may be an approach to incorporate the use of psychological interventions.

Effects of exposure to rocket attacks on adolescent distress and violence: a 4-year longitudinal study.

OBJECTIVE: The effects of Israeli adolescents' exposure to rocket attacks over time were examined, focusing on anxiety, depression, aggression, and violence commission. METHOD: A sample of 362 adolescents from southern Israel was followed from 2008 through 2011 with four annual assessments. Measures included exposure to rocket attacks (gauging whether children were affected by rocket attacks, both directly and indirectly, through friends and family), anxiety (items from the State Anxiety Inventory), depression (the Center for Epidemiological Studies Child Depression Scale), aggression (the Orpinas Aggression Scale), and violence commission (from the Social and Health Assessment). RESULTS: Concurrent and longitudinal findings differed. Wave 1 exposure to rockets attacks was associated with Wave 1 anxiety, depression, and aggression. Longitudinal results evinced only modest effects of exposure on anxiety and depression, no effects on aggression, but robust effects on violence commission. Exposure to terror attacks before the study predicted increased odds of violence commission at the fourth and final wave, controlling for violence commission at the first, second, and third wave. Exposure to rocket attacks in the second wave predicted increased odds of violence commission at the third wave. CONCLUSION: This is the first longitudinal study attesting to the prospective longitudinal effect of exposure to terrorism on adolescent violence. Findings should serve as a red flag for health care practitioners working in civil areas afflicted by terrorism and political violence.

Teacher-student relationship climate and school outcomes: implications for educational policy initiatives.

In recent discussions regarding concerns about the academic achievement of US students, educational policy makers have suggested the implementation of certain teacher policies. To address the limited empirical research on the putative educational impact of such policies, this study used multilevel structural equation models to investigate the longitudinal associations between teacher evaluation and reward policies, and student mathematics achievement and dropout with a national sample of students (n = 7,779) attending one of 431 public high schools. The student sample included an equal number of boys and girls averaging 16 years of age, and included a White (53%) majority. This study examined whether associations between teacher policies and student achievement were mediated by the teacher-student relationship climate. Results of this study were threefold. First, teacher evaluation policies that allowed students to evaluate their teachers were associated with more positive student reports of the classroom teaching climate. Second, schools with teacher reward policies that included assigning higher performing teachers with higher performing students had a negative association with student perceptions of the teaching climate. Lastly, schools with better student perceptions of the teaching climate were associated with lower student dropout rates by students' senior year. These findings are discussed in light of their educational policy implications.

Support for a dimensional view of autism spectrum disorders in toddlers.

We examined whether clinically distinct subgroups can be derived from a sample of toddlers (n = 186) who failed the Modified Checklist for Autism in Toddlers, received a comprehensive clinical evaluation, and were diagnosed with an autism spectrum disorder (ASD). Three subgroups emerged from cluster analysis distinguished by (a) social, communication, and intellectual skills and (b) the rate and intensity of repetitive behaviors and abnormal sensory response. Preoccupations, compulsions, and rituals did not distinguish resultant subgroups. These results support a dimensional diagnostic view of ASDs in toddlers since subgroup differences were based on symptom severity rather than different symptom profiles. Results also identify specific types and levels of behavioral deficit relevant to toddler populations. Implications for early diagnosis are discussed.

Trajectories of pure and co-occurring internalizing and externalizing problems from age 2 to age 12: findings from the National Institute of Child Health and Human Development Study of Early Child Care.

How and why do internalizing and externalizing problems, psychopathological problems from different diagnostic classes representing separate forms of psychopathology, co-occur in children? We investigated the development of pure and co-occurring internalizing and externalizing problems from ages 2 to 12 with the use of latent class growth analysis. Furthermore, we examined how early childhood factors (temperament, cognitive functioning, maternal depression, and home environment) and early adolescent social and behavioral adjustment variables were related to differential trajectories of pure and co-occurring internalizing and externalizing problems. The sample (National Institute of Child Health and Human Development Study of Early Child Care) consisted of 1,232 children (52% male). Mother reports on the Child Behavior Checklist (Achenbach, 1991, 1992) were used to construct the trajectories of externalizing and internalizing problems. Analyses identified groups of children exhibiting pure and co-occurring internalizing and externalizing problems. Children exhibiting continuous externalizing or continuous co-occurring internalizing and externalizing problems across the 10-year period under investigation were more likely to (a) engage in risky behaviors, (b) be associated with deviant peers, (c) be rejected by peers, and (d) be asocial with peers at early adolescence. However, children exhibiting pure internalizing problems over time were only at higher risk for being asocial with peers as early adolescents. Moreover, the additive effects of individual and environmental early childhood risk factors influenced the development of chronic externalizing problems, although pure internalizing problems were uniquely influenced by maternal depression. Results also provided evidence for the concepts of equifinality and multifinality.

Self-concept development and measurement in children with mild intellectual disabilities.

OBJECTIVE: Using a multi-trait-multi-method technique, self-concept was analysed as a function of chronological age in children with mild intellectual disabilities. Also, relations between reading achievement and self-concept were measured. METHODS: Participants were assessed on the Woodcock Reading Mastery Test-Revised, the Pictorial Scale of Perceived Competence and Social Acceptance and the Self-Description Questionnaire I--Individual Administration. RESULTS: A median split was run to divide participants into younger and older groups; older participants evidenced coefficients that revealed more multidimensionality, stability and discriminant validity. Also, a significant canonical correlation was found between the Harter Pictorial Scale at Time 1 and WRMT-R at Time 2, chi(2)(8) = 17.99, r = 0.62, p = 0.02. CONCLUSION: As a whole, these results suggest that children with intellectual disabilities evince self-concept development similar to what would be expected in typically-developing children.

Disentangling adolescent pathways of sexual risk taking.

Using data from the National Longitudinal Survey of Youth, the authors aimed to describe the pathways of risk within sexual risk taking, alcohol use, and delinquency, and then identify how the trajectory of sexual risk is linked to alcohol use and delinquency. Risk trajectories were measured with adolescents aged 15-24 years (N = 1,778). Using Latent Class Growth Analyses (LCGA), models indicated that the majority of adolescents engaged in sexual risk and alcohol use. In joint trajectory analyses, LCGA revealed six risk taking classes: sex and alcohol, moderate risk taking, joint risk taking, moderate alcohol, alcohol risk, and alcohol and delinquency experimentation. Editors' Strategic Implications: School administrators and curriculum designers should pay attention to the study's findings with respect to the need for prevention programs to target early adolescents and integrate prevention messages about alcohol use and sexual risk taking.

Terrorism-related perceived stress, adolescent depression, and social support from friends.

BACKGROUND: Terrorism leads to adolescent depression, but little is known about protective factors. We investigated 90 adolescents (in grades 7-9) residing in Dimona, Israel, before and after their exposure to a suicide bombing. OBJECTIVE: To examine the prospective effect of social support from friends, parents, and school personnel on the link between bombing-related perceived stress and adolescent depression. METHODS: Seven months prior to the suicide bombing, adolescents completed questionnaires as part of an ongoing investigation of youth risk/resilience under stress. The focus of the present study was on the Perceived Social Support Scale. One month subsequent to the suicide bombing, participants were interviewed by telephone about their bombing-related perceived stress (a 1-item measure) and depression (the Center for Epidemiologic Studies Child Depression Scale). RESULTS: Bombing-related perceived stress was associated with an increase in continuous levels of depression from before to after the bombing (beta = .29; P = .006). Prebombing social support from friends buffered against this effect (beta = -.29; P = .010). Adolescents reporting high bombing-related perceived stress evinced an increase in depression if they reported low levels of friends' support (beta = .61; P < .001) but not high levels of friends' support (beta = .00; P = .98). In addition, social support from friends predicted an increase in adolescent depression over time when bombing-related perceived stress was low (beta = .34; P = .026). CONCLUSION: In adolescence, social support from friends might protect against the depressogenic effect of terrorism-related perceived stress.