Reconciling multiple sources of influence: Longitudinal associations among perceived parent, closest friend, and popular peer injunctive norms and adolescent substance use.

Prospective associations over a 5-year period were examined among perceived parent, closest friend, and popular peer injunctive norms and the onset and frequency of adolescent substance use within a diverse (53% female, 45.5% White non-Hispanic, 22.3% Hispanic, 21.5% Black, 1% Asian, and 6.4% another race) sample of 868 seventh- and eighth-grade adolescents from 2012 to 2017. Analyses revealed adolescents' substance use norms were more lenient than perceptions of their parents' and stricter than perceptions of their closest friends'. Stricter perceptions of parent and closest friend norms, but not popular peer norms, were significantly associated with a later onset of alcohol, marijuana, and cigarette use, and the magnitude of the effect of each source' on later substance use varied across development.

Interpersonal Life Stress and Inflammatory Reactivity as Prospective Predictors of Suicide Attempts in Adolescent Females.

Adolescents' suicidal behavior frequently is preceded by interpersonal stress, but not all who experience distress attempt to end their lives. Recent theories have posited individual differences in stress-related inflammatory reactivity may be associated with psychopathology risk; this study examined inflammatory reactivity as a moderator of the prospective association between interpersonal stress and adolescents' suicidal behavior. Participants included 157 at-risk adolescent females (ages 12 to 16 years) and assessed individual differences in proinflammatory cytokine responses to a brief laboratory-based social stressor, both interpersonal and non-interpersonal life events, and suicidal behavior over an 18-month follow-up period. Measuring levels of the key proinflammatory cytokines interleukin-1ß (IL-1ß), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) before and after an experimentally-induced social stressor, results revealed that blunted cytokine reactivity heightened the effect of high interpersonal stress exposure on risk for suicidal behaviors over the subsequent 9 months. Significant effects were not revealed for non-interpersonally themed stress. Finding highlight the urgent need for more research examining inflammation reactivity among adolescents.

Effects of acute estradiol and progesterone on perimenstrual exacerbation of suicidal ideation and related symptoms: a crossover randomized controlled trial.

Female suicide attempts peak peri-menstrually-around the onset of menses-when the ovarian steroids estradiol (E2) and progesterone (P4) fall rapidly. Given preclinical evidence that withdrawal from either E2 or P4 can provoke behaviors consistent with elevated suicide risk, we hypothesized that withdrawal from one or both of these steroids contributes to perimenstrual exacerbation of suicidal ideation (SI) and related symptoms. In a randomized, controlled, double-blind crossover experiment (NCT03720847), a transdiagnostic sample of naturally cycling, medically healthy psychiatric outpatients reporting past-month SI completed two conditions during two different 14-day experimental intervals (days 7-20 where the luteinizing hormone surge = day 0), separated by a monthlong washout cycle. In the E2 and P4 (EP) condition, participants received transdermal E2 (0.1 mg/day) plus oral micronized P4 (200 mg/day as 100 mg twice daily) to buffer perimenstrual steroid withdrawal. A matched placebo (PBO) condition allowed natural perimenstrual steroid withdrawal. Participants reported daily SI and planning (primary outcomes) and indices of depression (low mood, hopelessness), threat sensitivity (anxiety, perceived stress), executive functioning (difficulty concentrating, impulsivity), and social cognitive bias (rejection sensitivity, perceived burdensomeness). In baseline cycles, no participant met prospective criteria for DSM-5 premenstrual dysphoric disorder, but 59% met all criteria except full follicular symptom remission, and 93% showed the highest SI in the perimenstrual phase. Of 29 randomized, 28 were analyzed (14 EP-PBO, 14 PBO-EP). Experimental administration of E2 and P4 (relative to PBO) reduced perimenstrual exacerbation of SI, suicide planning, depression, hopelessness, perceived stress, rejection sensitivity, and perceived burdensomeness, particularly in the perimenstrual (natural E2 and P4 withdrawal) days. Further, delayed withdrawal from experimental E2 and P4 (but not PBO) recapitulated SI, hopelessness, and rejection sensitivity. Acute perimenstrual withdrawal from ovarian steroids may play a causal role in perimenstrual worsening of depression and SI.

Exploring joint HPA-inflammatory stress response profiles in adolescent girls: Implications for developmental models of neuroendocrine dysregulation.

Prior research has struggled to differentiate cortisol stress response patterns reflective of well-regulated versus dysregulated hypothalamic-pituitary-adrenal (HPA) axis function among adolescents. Here, we show how exploring profiles of joint HPA-inflammatory stress responsivity, and linking those profiles to pubertal development and peer stress exposure may aid such distinction. Adolescent girls (N = 157, Mage  = 14.72 years, SD = 1.38) at risk for psychopathology completed assessments of salivary cortisol and pro-inflammatory cytokines (i.e., tumor necrosis factor-α, interleukin-1ß, and interleukin-6) prior to and following the Trier Social Stress Test. Adolescents, a close friend, and a caregiver completed questionnaire measures of peer stress and pubertal status. Multitrajectory modeling of adolescents' cortisol and cytokine levels revealed three profiles: low cortisol response-stably low cytokine (n = 75), high cortisol response-stably moderate cytokine (n = 47), and low cortisol response-stably high cytokine (n = 35). Relative to low cortisol response-stably low cytokine, adolescents exhibiting the high cortisol response-stably moderate cytokine profile were more advanced in their pubertal development, but presented with similarly low levels of peer stress exposure. Despite showing cortisol responses that were indistinguishable from low cortisol response-stably low cytokine, adolescents exhibiting the low cortisol response-stably high cytokine profile were more pubertally advanced, but also more likely to have experienced chronic peer strain (self-report) and relational peer victimization (close friend-report). These findings thus illustrate the potential value of taking a multisystem approach to studying adolescent stress responsivity and underscore the importance of considering developmental and social factors when interpreting cortisol stress response patterns. Ultimately, such work may help inform developmental models of neuroendocrine dysregulation and related risk for psychopathology.

Interpersonal life stress, inflammation, and depression in adolescence: Testing Social Signal Transduction Theory of Depression.

BACKGROUND: Depression rates increase markedly for girls across the adolescent transition, but the social-environmental and biological processes underlying this phenomenon remain unclear. To address this issue, we tested a key hypothesis from Social Signal Transduction Theory of Depression, which posits that individuals who mount stronger inflammatory responses to social stress should exhibit greater increases in depressive symptoms following interpersonal life stress exposure than those who mount weaker inflammatory responses to such stress. METHOD: Participants were 116 adolescent girls (Mage = 14.71) at risk for psychopathology, defined as having a history of mental health concerns (e.g., psychiatric treatment, significant symptoms) over the past 2 years. At baseline, we characterized their inflammatory reactivity to social stress by quantifying their salivary proinflammatory cytokine responses to a laboratory-based social stressor. Then, 9 months later, we assessed the interpersonal and noninterpersonal stressful life events that they experienced over the prior 9 months using an interview-based measure of life stress. RESULTS: As hypothesized, greater interpersonal life stress exposure was associated with significant increases in depression over time, but only for girls exhibiting stronger salivary tumor necrosis factor-α and interleukin-1ß reactivity to social stress. In contrast, noninterpersonal stress exposure was unrelated to changes in depression longitudinally, both alone and when combined with youths' cytokine reactivity scores. DISCUSSION: These results are consistent with Social Signal Transduction Theory of Depression and suggest that heightened inflammatory reactivity to social stress may increase adolescents' risk for depression. Consequently, it may be possible to reduce depression risk by modifying inflammatory responses to social stress.

Modeling Heterogeneous Peer Assortment Effects Using Finite Mixture Exponential Random Graph Models.

This article develops a class of models called sender/receiver finite mixture exponential random graph models (SRFM-ERGMs). This class of models extends the existing exponential random graph modeling framework to allow analysts to model unobserved heterogeneity in the effects of nodal covariates and network features without a block structure. An empirical example regarding substance use among adolescents is presented. Simulations across a variety of conditions are used to evaluate the performance of this technique. We conclude that unobserved heterogeneity in effects of nodal covariates can be a major cause of misfit in network models, and the SRFM-ERGM approach can alleviate this misfit. Implications for the analysis of social networks in psychological science are discussed.

Peer victimization predicts heightened inflammatory reactivity to social stress in cognitively vulnerable adolescents.

BACKGROUND: During adolescence, peer victimization is a potent type of social stressor that can confer enduring risk for poor mental and physical health. Given recent research implicating inflammation in promoting a variety of serious mental and physical health problems, this study examined the role that peer victimization and cognitive vulnerability (i.e. negative cognitive styles and hopelessness) play in shaping adolescents' pro-inflammatory cytokine responses to an acute social stressor. METHODS: Adolescent girls at risk for psychopathology (n = 157; Mage  = 14.73 years; SD = 1.38) were exposed to a laboratory-based social stressor before and after which we assessed salivary levels of three key pro-inflammatory cytokines - interleukin-6 (IL-6), interleukin-1ß (IL-1ß), and tumor necrosis factor-α (TNF-α). RESULTS: As hypothesized, adolescents with greater peer victimization exposure exhibited greater increases in IL-6 and IL1-ß in response to the laboratory-based social stressor. Moreover, for all three cytokines individually, as well as for a combined latent factor of inflammation, peer victimization predicted enhanced inflammatory responding most strongly for adolescents with high levels of hopelessness. CONCLUSIONS: The findings reveal a biological pathway by which peer victimization may interact with cognitive vulnerability to influence health in adolescence.

Patient and Provider Perspectives on Communication About Body Image With Adolescents and Young Adults With Cystic Fibrosis.

Objective: This mixed-methods study examined perspectives of adolescents and young adults (AYAs) with cystic fibrosis (CF) and health care providers on body image communication. Methods: Interviews and questionnaires were completed by 20 AYAs and 28 providers. Results: Although 85% of patients reported they had never had a body image conversation with a health care provider, 74% of providers reported discussing this topic with patients. Patients and providers described body image as an important issue, which should be discussed comfortably and supportively. However, patients often preferred to discuss body image as a distinct topic, separate from physical health, whereas providers preferred integrating body image conversations within weight- and health-based discussions. Conclusions: Body image is an important topic for AYAs with CF that often goes unaddressed or addressed in ways that are less preferred by patients. Providers should reduce barriers to effective communication about this important topic, particularly through increased awareness of AYA preferences.

Early Adolescent Friendship Selection Based on Externalizing Behavior: the Moderating Role of Pubertal Development. The SNARE Study.

This study examined friendship (de-)selection processes in early adolescence. Pubertal development was examined as a potential moderator. It was expected that pubertal development would be associated with an increased tendency for adolescents to select their friends based on their similarities in externalizing behavior engagement (i.e., delinquency, alcohol use, and tobacco use). Data were used from the first three waves of the SNARE (Social Network Analysis of Risk behavior in Early adolescence) study (N = 1144; 50 % boys; M age = 12.7; SD = 0.47), including students who entered the first year of secondary school. The hypothesis was tested using Stochastic Actor-Based Modeling in SIENA. While taking the network structure into account, and controlling for peer influence effects, the results supported this hypothesis. Early adolescents with higher pubertal development were as likely as their peers to select friends based on similarity in externalizing behavior and especially likely to remain friends with peers who had a similar level of externalizing behavior, and thus break friendship ties with dissimilar friends in this respect. As early adolescents are actively engaged in reorganizing their social context, adolescents with a higher pubertal development are especially likely to lose friendships with peers who do not engage in externalizing behavior, thus losing an important source of adaptive social control (i.e., friends who do not engage in externalizing behavior).

Friendship quality and health-related outcomes among adolescents with cystic fibrosis.

OBJECTIVE: During adolescence, the significance of peer relationships peaks, and the presence and quality of dyadic friendships impact psychosocial outcomes. Yet, friendships have been studied infrequently among youth with chronic illness, particularly youth with cystic fibrosis (CF). The current aims were to (1) describe friendships among adolescents with CF, including number, duration, frequency of interactions, and positive/negative friendship qualities, and (2) explore associations between friendship quality, treatment adherence, and health-related quality of life. METHODS: Participants (N = 42) reported on friendships with peers with and without CF; caregivers reported on adolescents' adherence and quality of life. RESULTS: Friendships with CF-peers were less common and lower quality than friendships with non-CF peers. Both positive and negative friendship qualities were associated with adherence; positive friendship qualities were uniquely associated with quality of life. CONCLUSIONS: CF-related health promotion efforts may benefit from addressing the impact of friendships on adherence and quality of life.

Adolescent non-suicidal self-injury: a cross-national study of community samples from Italy, the Netherlands and the United States.

This study examined rates and correlates of non-suicidal self-injury (NSSI) across three non-clinical adolescent samples from different countries. Surveys were administered to 1862 adolescents (M(age)=15.69, S.D.=0.87) from Italy (n=827), the Netherlands (n=675), and United States (n=360), including measures of NSSI, substance use, internal (i.e., depressive symptoms, loneliness), and interpersonal factors (i.e., peer victimization, peer preference). After controlling for socio-demographic differences, similar prevalence of NSSI was found across the three samples, with approximately 24% of the adolescents reporting at least one NSSI episode within the last year. Multivariate logistic regressions showed that adolescents' victimization and higher levels of depressive symptoms and family-related loneliness were associated concurrently with NSSI comparably in all three samples. However, multi-group analyses indicated that the association between NSSI and substance use varied significantly across samples, indicating that NSSI related more strongly to substance use (i.e., cigarette smoking and frequent marijuana use) in the sample from the United States rather than the samples from the Netherlands and Italy. Findings provide evidence of NSSI and suggest high similarities in rates and correlates across samples from different countries. Future research should further explore NSSI cross-nationally.

Psychological, peer, and family influences on smoking among an adolescent psychiatric sample.

Although much is known about adolescent cigarette use and initiation in community samples, less is known about these factors among adolescents in clinic-referred populations or those with severe psychopathology. Data were collected from 106 adolescents aged 12 to 15 years (M = 13.6, SD = 0.74) recruited from a psychiatric inpatient facility. Hierarchical logistic regressions assessed the relationship among psychological, peer, and family environment factors and smoking at baseline and 18 months posthospitalization. Conduct problem symptoms, friends' cigarette use, and friends' marijuana use were associated with greater odds of lifetime and current smoking at baseline but not at follow-up. After accounting for the significant effect of baseline use, greater family conflict predicted decreased odds of having initiated smoking at the 18-month follow-up. The period following inpatient psychiatric hospitalization may represent an important window for smoking cessation and prevention efforts targeting peer and family factors, especially for youth with externalizing problems.

High peer popularity longitudinally predicts adolescent health risk behavior, or does it?: an examination of linear and quadratic associations.

OBJECTIVE: In contrast to prior work, recent theory suggests that high, not low, levels of adolescent peer popularity may be associated with health risk behavior. This study examined (a) whether popularity may be uniquely associated with cigarette use, marijuana use, and sexual risk behavior, beyond the predictive effects of aggression; (b) whether the longitudinal association between popularity and health risk behavior may be curvilinear; and (c) gender moderation. METHODS: A total of 336 adolescents, initially in 10-11th grades, reported cigarette use, marijuana use, and number of sexual intercourse partners at two time points 18 months apart. Sociometric peer nominations were used to examine popularity and aggression. RESULTS: Longitudinal quadratic effects and gender moderation suggest that both high and low levels of popularity predict some, but not all, health risk behaviors. CONCLUSIONS: New theoretical models can be useful for understanding the complex manner in which health risk behaviors may be reinforced within the peer context.

Romantic partner selection and socialization of young adolescents' substance use and behavior problems.

This study examined romantic partner selection and socialization of substance use (cigarettes, alcohol) and behavior problems among a sample of 78 young adolescents (6th-8th graders) over eleven months. Adolescent and romantic partner behaviors were assessed before and after relationships were initiated via school records and self-report. Most selection and socialization effects were apparent for the eighth grade adolescents (at Time 1). Prior to their relationship, eighth graders and romantic partners were alike on alcohol use. In contrast, romantic socialization effects emerged for eighth graders' cigarette use and behavior problems. The nature of the partner socialization effects depended on the combination of adolescents' and partners' pre-relationship behaviors. Eighth graders who dated partners with fewer problems showed the greatest instability in their behavior problems and partner behavior predicted greater decreased in problem behaviors among adolescents with more problems. The implications of these findings are discussed within the broader context of adolescent peer relationships.

Childhood depressive symptoms and adolescent cigarette use: a six-year longitudinal study controlling for peer relations correlates.

OBJECTIVE: To examine potential pathways between childhood depressive symptoms and adolescent cigarette use, controlling for potential "third variable" causes. DESIGN: Participants included 250 youth (60% girls) who were in Grades 4 to 6 at study outset and in Grades 10 to 12 (M age = 16.78) at a 6-year follow-up. At Time 1, children completed measures of depressive symptoms, as well as peer nominations of peer acceptance, rejection, and aggressive behavior. MAIN OUTCOME MEASURES: Time 2 measures included adolescents' own and close friends' cigarette use, depressive symptoms, and externalizing behaviors; parents also reported on adolescent behaviors. RESULTS: Higher levels of childhood depressive symptoms and aggressive behavior were associated longitudinally with cigarette use in adolescence. After controlling for other associations, higher levels of childhood depressive symptoms also were associated with higher levels of friends' cigarette use in adolescence and higher levels of adolescent depressive symptoms; each of these adolescent outcomes was concurrently associated with cigarette use. CONCLUSION: Depressive symptoms in childhood may lead to altered developmental trajectories that either directly or indirectly contribute to adolescent outcomes, including cigarette use.

A prospective study of perception in adolescent smoking.

PURPOSE: This prospective study examined how environmental smoking affects the perception of lifetime smoking prevalence and thereby the likelihood of subsequent regular smoking. METHODS: A longitudinal design (N = 6769) with three waves was used to test our research questions. Exposure to smoking by peers, best friends, and parents were assessed at T1. Perception of lifetime smoking prevalence was calculated at T2. Adolescent smoking was assessed at three waves. RESULTS: Overestimation of lifetime smoking prevalence was predicted by having a predominantly smoking peer group, having a best friend who smokes, and by having at least one parent who smokes. In consistency with a false consensus effect, smokers were more susceptible to overestimate lifetime smoking prevalence than nonsmokers. Subsequently, while controlling for smoking at T2, overestimating lifetime smoking prevalence was predictive of regular smoking at T3 (in accordance with the conformity hypothesis). Specifically, overestimation of lifetime smoking appeared to mediate the effects of environmental smoking (peers, best friends, and parents) on adolescent smoking. No support was found for a moderation effect of exposure to environmental smoking on the link between misperception of lifetime smoking prevalence and regular smoking. CONCLUSIONS: The study offers a rare and needed theoretical and empirical research examining environmental and individual predictors of regular smoking. Besides direct prevention of exposure to smoking, cognitions that are a product of exposure to smoking need to be addressed in prevention campaigns.

Adolescent girls' and boys' weight-related health behaviors and cognitions: associations with reputation- and preference-based peer status.

In this study, the authors examined associations between preference- and reputation-based peer status and weight-related behaviors and cognitions for both adolescent boys and girls. Sociometric measures of peer like-ability and peer-perceived popularity, as well as self-reported measures of body size, dieting behavior, and weight-related cognitions were collected from a sample of 441 adolescents in Grades 11 and 12. Results revealed weight-related cognitions for girls (concerning obesity) and boys (concerning musculature/fitness). Peer-perceived popularity, but not like-ability, was significantly associated with both boys' and girls' body size and dieting. Lower levels of popularity were associated with heavier body shapes for girls and with both thin and heavier body shapes for boys. Findings suggest that peer status is an important source of social reinforcement associated with weight-related behaviors and cognitions.

Childhood peer rejection and aggression as predictors of adolescent girls' externalizing and health risk behaviors: a 6-year longitudinal study.

This 6-year longitudinal study examined girls' peer-nominated social preference and aggression in childhood as predictors of self- and parent-reported externalizing symptoms, substance use (i.e. cigarette, alcohol, and marijuana use), and sexual risk behavior in adolescence. Participants were 148 girls from diverse ethnic backgrounds, who were initially assessed in Grades 4-6 and again in Grades 10-12. Results supported a moderator model, indicating that social preference changed the nature of the association between childhood aggression and adolescent outcomes. When accompanied by peer rejection, aggressive behavior was moderately stable over time and significantly associated with adolescent girls' substance use and sexual risk behavior. However, under conditions of peer acceptance, no significant association between childhood aggression and adolescent outcomes emerged.