Mental-health profiling with person-centred analysis: A study of adolescents in Sweden.

BACKGROUND: Studies that have examined time trends in adolescents' mental health have frequently been based on analyses of adolescents' psychosomatic symptoms. Adolescents' reports of psychosomatic complaints need to be seen in the light of their overall evaluations of their health. The objectives of this study were to apply a person-centred approach to identifying adolescents' mental-health profiles based on evaluations of their overall health and psychosomatic complaints. The relationships between these mental-health profiles and indicators of positive mental health and psychological and social-adjustment problems are examined. METHODS: A dual-factor approach was used for nationally representative adolescent samples and examined adolescents' self-rated psychosomatic complaints and perceived overall health simultaneously. Cluster analyses of data from the Swedish Health Behaviour in School-aged Children (HBSC) 2017/18 survey, including 3222 children aged 11, 13 and 15, were used to identify mental-health profiles. RESULTS: Four mental-health profiles were identified by cluster analyses in all age groups. The profiles showed good construct validity in relation to mental well-being, life satisfaction and self-esteem. The poorest psychological adjustment was found among the adolescents with high levels of psychosomatic symptoms together with low levels of perceived overall health. Adolescents with high levels of psychosomatic symptoms only or with low levels of overall health only showed considerably better psychological adjustment. CONCLUSIONS: Cluster analyses identified distinct, valid and consistent mental-health profiles based on differing levels of perceived health and psychosomatic complaints. The dual-factor model in population health research may increase our potential to understand the mental health of adolescents better.

Basic Values Transform Political Interest into Diverse Political Values, Attitudes and Behaviors.

Since politically interested adolescents do not necessarily present humanistic, environmental and democratic values, this study addresses the hitherto ignored role that how these basic human values play in politically interested adolescents' political values, attitudes and behaviors. A cluster analysis of 857 Swedish upper-secondary students (50.8% girls, Mage = 16.62, SD = 0.71) identified politically interested adolescents who attached high levels of importance to others' welfare and politically interested adolescents who attached low levels of importance. They differed on most comparative measures: environmental values, inclusive attitudes towards immigrants, support of democratic principles, trust in social movements, and readiness to step in if something jeopardizes the welfare of others. The conclusion is that the value of attaching high importance to others' welfare or not transforms youth's political interest into diverse attitudes and behaviors. The cluster group of politically interested adolescents who attached low importance to others' welfare largely consisted of males.

Why Some Adolescents Are Open To Their Parents' Political Communication.

This study examines the conditions that make adolescents open to their parents' attempts at political socialization. Based on a reformulation of the perceptual accuracy argument, that parents' messages are filtered through correct perceptions of these messages by adolescents, the study suggests that adolescents who accurately recognize their parents' high political sophistication are particularly likely to attend to and be open to their parents' political communication. This proposition was tested using cluster analysis of a sample of 505 Swedish upper-secondary students and their parents (51% girls; Mage = 16.56, SD = 0.67). The analysis yielded two clusters where adolescents correctly identified (26%) and failed to correctly identify (22%) their parents' high political sophistication, and three clusters where both parents and adolescents reported low or medium parental political sophistication (10%, 11%, and 32%). In confirmation of the hypothesis, members of the cluster group of adolescents who correctly recognized their parents' high political sophistication were particularly aware of parents' political socialization attempts and receptive to parents' political communication. Moreover, these youth considered their parents' political views as important and, accordingly, seemed to perceive their parents as political role models.

Ethnic Harassment and Immigrant Youth's Engagement in Violent Behaviors: Understanding the Risk Factors.

The present study aimed to examine whether ethnic harassment was related to violent behaviors among immigrant youth over time and to identify the risk factors. The sample comprised immigrant adolescents living in Sweden (N = 365; Mage  = 13.93, SD = 0.80). Results showed that the more youth were ethnically harassed, the more they engaged in violent acts over time. A separated identity significantly moderated the effect of ethnic harassment on youth's engagement in violent behaviors. Specifically, ethnic harassment positively predicted engagement in violent behaviors only at high levels of separated identity. Impulsivity and school ethnic composition did not act as moderators. The findings suggest that preventing violent behaviors among immigrant youth requires a focus on promoting positive interethnic relationships, and multicultural identity among immigrant youth.

Derisive Parenting Fosters Dysregulated Anger in Adolescent Children and Subsequent Difficulties with Peers.

Bullying and victimization are manifest in the peer social world, but have origins in the home. Uncertainty surrounds the mechanisms that convey problems between these settings. The present study describes the indirect transmission of hostility and coercion from parents to adolescent children through emotional dysregulation. In this model, derisive parenting-behaviors that demean or belittle children-fosters dysregulated anger, which precipitates peer difficulties. A total of 1409 participants (48% female; Mage = 13.4 years at the outset) were followed across secondary school (Grades 7-9) for three consecutive years. The results indicated that derisive parenting in Grade 7 was associated with increases in adolescent dysregulated anger from Grade 7 to 8, which, in turn, was associated with increases in bullying and victimization from Grade 8 to 9. The findings suggest that parents who are derisive, have children who struggle with emotional regulation and, ultimately, with constructive peer relationships.

Adolescents Who Self-Harm: The Patterns in Their Interpersonal and Psychosocial Difficulties.

We proposed that having mutually hostile interactions with others is a strong environmental stress factor that, together with diverse psychosocial problems, characterizes adolescents who self-harm. Using cluster analysis, this study examined the naturally occurring patterns of hostility conditions and psychosocial difficulties in a normative sample of 2,029 adolescents (50% boys; Mage  = 13.89). Results showed that self-harming behavior was significantly higher among the subgroup of adolescents with mutually hostile interactions who exhibited both internalizing and externalizing problems than among adolescents with other interpersonal-psychosocial configurations. Also, this subgroup of adolescents reported high impulsivity, anger dysregulation, and low self-esteem. These findings support recent research that indicates that adolescents who self-harm also tend to expose others to hostility and display externalizing symptoms.

The severity and spread of adjustment problems of adolescents involved in mutually hostile interactions with others.

In the literature, bully-victims report a wider range of adjustment problems than "pure" bullies or victims. This may not be confined to the school context, but might be found in other settings as well. Involvement in mutually hostile interactions across everyday settings may more reflect adolescents' characteristic way of handling conflicts with others. We used data from a longitudinal study of a community sample of adolescents (N = 992). Cluster analyses for specific everyday settings and across settings yielded clusters high on both exposing others and being exposed to hostility. Adolescents in these clusters, and particularly across settings, reported a wider range of externalizing, internalizing, and academic problems, than adolescents in other cluster groups. Longitudinal analyses showed support for bidirectional relationships between mutually hostile conditions and problematic adjustment. We conclude that adolescents' mutual hostility experiences are associated with profoundly problematic adjustment.

Adolescent psychopathology in times of change: Introduction to the special issue.

The aim of this special issue is to understand better the many changes in adolescent psychopathology have taken place over the last decades. The factors associated with adjustment problems and psychopathology in adolescence today are not necessarily the same as the factors that predicted problems and psychopathology in the past. But the basic strategies for connecting negative experiences with adolescent psychopathology remain as important today as they were for understanding adolescent psychopathology decades ago. This is well exemplified in the studies included in this Special Issue. What all this studies have in common is that parenting and the family environment are assumed to play a key role in adolescents' adjustment and psychopathology. Finally, given that all papers in this special issue are based on conference presentations at the 15th Biennial Conference of the European Association for Research on Adolescence (EARA), some more information on that conference in included in this introduction.

Adolescents' Engagement in Ethnic Harassment: Prejudiced Beliefs in Social Networks and Classroom Ethnic Diversity.

Research on ethnic victimization to date has done little to identify the reasons why adolescents victimize their peers due to their ethnic background. To address this limitation, we examined: (1) the extent to which prejudiced attitudes within adolescents' close and larger social networks determine their engagement in ethnic harassment, and (2) the extent to which classroom ethnic diversity plays a role in any such link. Our sample included 902 Swedish adolescents (M age = 14.40, SD = .95; 50.3% girls). We found that Swedish adolescents who held negative attitudes toward immigrants or who were surrounded by prejudiced peers were more likely to be involved in ethnic harassment, particularly in classrooms with high ethnic diversity. Adolescents in classrooms with a high anti-immigrant climate were more likely to harass their immigrant peers. These findings suggest that prejudiced beliefs in youth social networks put young people at risk of engaging in ethnic harassment, particularly in ethnically diverse classrooms.

Best Friend Influence Over Adolescent Problem Behaviors: Socialized by the Satisfied.

The present study was designed to examine best friend influence over alcohol intoxication and truancy as a function of relative perceptions of friendship satisfaction. The participants were 700 adolescents (306 boys, 394 girls) who were involved in same-sex best friendships that were stable from one academic year to the next. Participants completed self-report measures of alcohol intoxication frequency and truancy at 1-year intervals. Each member of each friendship dyad also rated his or her satisfaction with the relationship. At the outset, participants were in secondary school (approximately 13-14 years old) or high school (approximately 16-17 years old). More satisfied friends had greater influence than less satisfied friends over changes in intoxication frequency and truancy. Problem behaviors of less satisfied friends increased over time if the more satisfied friend reported relatively higher, but not relatively lower, initial levels of drinking or truancy. The results support the hypothesis that adolescent friends are not similarly influential. The power to socialize, for better and for worse, rests with the partner who has a more positive perception of the relationship.

The moderating role of parenting on the relationship between psychopathy and antisocial behavior in adolescence.

We aimed to analyze the impact of several parenting factors on the relationship between psychopathy and antisocial behavior. Nine hundred youths and their mothers reported on parent-youth interactions, and youth self-report measures of psychopathy, delinquency and violent behavior were taken. Multiple regression was used to test for the significance of interactions between parenting and psychopathy scores. In terms of delinquency, linear interactions between psychopathy and the level of conflict with parents and parents' knowledge of their youths' whereabouts/youths' willingness to disclose information were found based on the data reported by the youths. Data reported by mothers indicated a linear interaction between psychopathy and parents' knowledge/youth disclosure, and a quadratic interaction of conflict with parents. For violence, we used logistic regression models to analyze moderation. No interaction effects between psychopahy scores and parenting factors were found. Youths' reports of high conflict with parents and parents' knowledge/youth disclosure showed to have an impact on violence regardless of the level of psychopathic traits. Implications for the prevention and treatment are discussed.

Toward a re-interpretation of self-harm: A cross-contextual approach.

A common view is that self-harmers are individuals who are exposed to or have been exposed to stressors and hostility in everyday settings. A strand of research has also found that self-harmers expose other people to their hostility. Extending these findings, this study examined whether adolescent self-harmers are simultaneously exposed and expose others to hostility in their everyday interpersonal contexts-at home, at school, and during leisure-time. The participants were 1,482 adolescents, ranging from 13 to 16 years of age, who attended different schools in a medium-sized city in central Sweden. The results show that the adolescents involved in mutually hostile relationships in their different interpersonal contexts exhibited higher self-harm than the adolescents who were exposed to others' hostility or exposed other people to their hostility. Also, the more mutually hostile settings the adolescents were involved in, the more self-harm they reported. Overall, our findings suggest not only that self-harmers are exposed to hostility in their different interpersonal contexts, as has been typically assumed, but also that they simultaneously expose others to hostility in these contexts. This has implications for our understanding of young people who harm themselves and also for intervention. Aggr. Behav. 42:522-532, 2016. © 2016 Wiley Periodicals, Inc.

Youth's Initiations of Civic and Political Discussions in Class: Do Youth's Perceptions of Teachers' Behaviors Matter and Why?

Teachers are thought to play an important role in fostering youth civic engagement; however, the current literature is limited with regard to providing concrete suggestions as to what teachers can do to promote youth civic engagement and why teachers have an impact on youth. To address these limitations, we simultaneously tested three alternative explanations to identify the critical way(s) in which perceived teachers' behaviors might contribute to youth civic engagement in school. We also investigated the underlying processes that may explain why youth's perceptions of teachers' behaviors matter, by focusing on the mediating roles of young people's feelings about politics and their political efficacy beliefs. The sample included 7th (n = 876, M age  = 13.42, SD = .71; 51 % girls) and 10th grade students (n = 857, M age  = 16.62, SD = .71; 51 % girls) residing in Sweden. Among the different aspects of perceived teacher behaviors, only an engaged and inspiring teaching style fostered youth's initiations of civic and political discussions in class over time among both early and late adolescents. Moreover, youth's feelings about politics significantly mediated the effect of perceived teachers' behaviors on youth civic engagement in class. Contrary to our expectation, youth's political efficacy did not act as a mediator. The present study sheds light on what teachers can do to promote youth civic and political engagement in a school setting.

Understanding the Link Between Pubertal Timing in Girls and the Development of Depressive Symptoms: The Role of Sexual Harassment.

The link between sexual maturation, or pubertal timing, in girls and adolescent depressive symptoms is well-documented, but the underlying processes remain unclear. We examined whether sexual harassment, which has previously been linked to both pubertal timing and depressive symptoms, mediates this link, using a two-wave longitudinal study including 454 girls in 7th (M age  = 13.42, SD = .53) and 8th grade (M age  = 14.42, SD = .55). Pubertal timing was linked to depressive symptoms in both age groups, and predicted an increase in depressive symptoms among the 7th graders. Sexual harassment significantly mediated the link between pubertal timing and depressive symptoms among the 7th, but not the 8th grade girls. Together, our findings suggest that one way to prevent depressive symptoms among early-maturing girls could be to address sexual harassment in preventive intervention in early adolescence.

Are adolescents' mutually hostile interactions at home reproduced in other everyday life contexts?

Children involved in mutually hostile interactions at home are at risk of experiencing adjustment problems in other everyday life contexts. However, little is known about whether the pattern of mutual hostility at home is reproduced by high-conflict youths in other interpersonal contexts. In this study, we examined whether adolescents involved in mutually hostile interactions with their parents encounter similar mutually hostile interactions in other interpersonal contexts. We used a longitudinal design, following mid-adolescents over 1 year (N = 2,009, 51% boys, Mage = 14.06, SD = 0.73). The adolescents were 7th and 8th grade students in a mid-sized town in Sweden. The results showed that the youths involved in mutual hostility at home were more likely to be involved in mutual hostility at school and in their free-time. A longitudinal relationship between mutual hostility at home and mutual hostility in other contexts was confirmed. Being involved in mutually hostile interactions at home at Time 1 increased adolescents' likelihood of getting involved in mutually hostile interactions with peers at school and in free-time at Time 2. Overall, the results point to the important role played by experiencing mutual hostility at home in maladaptive behaviors across everyday settings.

Under the surface of adolescent psychopathic traits: high-anxious and low-anxious subgroups in a community sample of youths.

In this study, we examined subgroups of adolescents based on their levels of psychopathic traits and anxiety. Participants were 914 youths from a community sample, with a mean age of 14.28 (SD = .94) years. We used adolescents' self-reports of psychopathic traits and their parents' reports of the adolescent's anxiety to identify distinct subgroups of youths. Using latent class analysis, we identified five groups that varied in levels of psychopathic traits and anxiety. Two groups were characterized by high levels of psychopathic traits and high or low scores on anxiety. Validation of these subgroups revealed that they differed significantly from each other in theoretically meaningful ways-the low-anxious subgroup reported higher levels of psychopathic traits, lower levels of impulsivity and hyperactivity, and lower levels of aggression than the high-anxious group. These findings are in line with previous empirical research and provide support that anxiety discriminates between two subgroups of adolescents with psychopathic traits.

Why and when is ethnic harassment a risk for immigrant adolescents' school adjustment? understanding the processes and conditions.

Ethnically harassed immigrant youth are at risk for experiencing a wide range of school adjustment problems. However, it is still unclear why and under what conditions experiencing ethnic harassment leads to school adjustment difficulties. To address this limitation in the literature, we examined two important questions. First, we investigated whether self-esteem and/or depressive symptoms would mediate the associations between ethnic harassment and poor school adjustment among immigrant youth. Second, we examined whether immigrant youths' perception of school context would play a buffering role in the pathways between ethnic harassment and school adjustment difficulties. The sample (n = 330; M age = 14.07, SD = .90; 49% girls at T1) was drawn from a longitudinal study in Sweden. The results revealed that experiencing ethnic harassment led to a decrease in immigrant youths' self-esteem over time, and that youths' expectations of academic failure increased. Further, youths' relationships with their teachers and their perceptions of school democracy moderated the mediation processes. Specifically, when youth had poor relationships with their teachers or perceived their school context as less democratic, being exposed to ethnic harassment led to a decrease in their self-esteem. In turn, they reported low school satisfaction and perceived themselves as being unsuccessful in school. Such indirect effects were not observed when youth had high positive relationships with their teachers or perceived their school as offering a democratic environment. These findings highlight the importance of understanding underlying processes and conditions in the examination of the effects of ethnic devaluation experiences in order to reach a more comprehensive understanding of immigrant youths' school adjustment.

Non-suicidal self-injury and depressive symptoms during middle adolescence: a longitudinal analysis.

Previous research has shown a consistent positive association between non-suicidal self-injury and depressive symptoms. However, the direction of the effects has not been examined. To understand whether non-suicidal self-injury predicts depressive symptoms or vice versa, we examined the relations between non-suicidal self-injury and depressive symptoms across three waves of self-report data collected 1 year apart from 506 Swedish adolescents (47% girls; M age = 13.21; SD = .57) who were attending 7th grade at the onset of the study. The results suggest that depressive symptoms predict increases in non-suicidal self-injury 1 year later between the first and second waves of the study. Between the second and third waves of the study depressive symptoms and non-suicidal self-injury were significantly correlated indicating co-occurrence with no direction of effect rather than depressive symptoms predicting non-suicidal self-injury or vice versa. Group comparisons revealed no differences for boys and girls. The findings help clarify the relationships between non-suicidal self-injury and depressive symptoms during middle adolescence.

Secular trends in mental health profiles among 15-year-olds in Sweden between 2002 and 2018.

Background: Studies of secular trends in mental unhealth indicate that adolescents in the Nordic countries, especially girls, have an increased reported prevalence of mental health problems the last decades. This increase needs to be seen in the light of the adolescents' assessments of their perceived overall health. Objective: To investigate whether a person-centered approach to research can enhance understanding of changes over time in the distribution of mental health problems among Swedish adolescents. Method: A dual-factor approach was used to study changes over time in mental health profiles among nationally representative 15-year-old adolescent samples from Sweden. Cluster analyses of subjective health symptoms (psychological and somatic) and perceived overall health from the Swedish Health Behavior in School-aged Children (HBSC) surveys of 2002, 2006, 2010, 2014, and 2018 were used to identify these mental health profiles (n = 9,007). Results: Four mental health profiles were identified by a cluster analysis which combined all five data collections-Perceived good health, Perceived poor health, High psychosomatic symptoms, and Poor mental health. There were no significant differences in the distributions of these four mental health profiles between the survey years 2002 and 2010, but substantial changes took place between 2010 and 2018. Here, particularly the High psychosomatic symptoms profile increased among both boys and girls. The Perceived good health profile decreased among both boys and girls, and the Perceived poor health profile decreased among girls. The profile involving the most pronounced mental health problems, the Poor mental health profile (perceived poor health, high psychosomatic problems), was stable from 2002 to 2018 among both boys and girls. Conclusion: The study shows the added value of using person-centered analyses to describe differences in mental health indicators between cohorts of adolescents over longer periods of time. In contrast to the long-term increase in mental health problems seen in many countries, this Swedish study did not find an increase among young persons, both boys and girls, with the poorest mental health, the Poor mental health profile. Rather, the most substantial increase over the survey years, predominantly between 2010 and 2018, was found among the 15-year-olds with High psychosomatic symptoms only.