Changes in adolescents' daily-life solitary experiences during the COVID-19 pandemic: an experience sampling study.

BACKGROUND: Adolescent solitude was drastically impacted by the COVID-19 pandemic. As solitude is crucial for adolescent development through its association with both positive and negative developmental outcomes, it is critical to understand how adolescents' daily-life solitary experiences changed as a result of the pandemic. METHODS: Using three waves of Experience Sampling Method data from a longitudinal study, we compared adolescents' daily-life solitary experiences in the early (nT1=100; MAge=16.1; SDAge=1.9; 93% girls) and mid-pandemic (nT2=204; MAge=16.5; SDAge=2.0; 79% girls) to their pre-pandemic experiences. RESULTS: We found that adolescents with lower levels of pre-pandemic social support and social skills reported wanting to be alone less and feeling like an outsider more at both time points during the pandemic. In the mid-pandemic wave, adolescents with higher levels of pre-pandemic social support and social skills reported decreases in positive affect compared to the pre-pandemic wave. CONCLUSION: This study shows that adolescents' daily-life solitary experiences worsened throughout the COVID-19 pandemic. There should be continued concern for the wellbeing of all adolescents, not only those already at risk, as effects of the pandemic on mental health might only manifest later.

Anticipating future threats: Evidence for association, but not interaction, of childhood adversity and identity development with threat anticipation in adolescence.

AIM: Childhood adversity may result in a negative expectation of future interactions with others, also referred to as 'threat anticipation'. It may also negatively impact on identity development, which subsequently may influence how individuals deal with their environment. Here, we examine the hypotheses that (1) identity synthesis is associated with reduced anticipation of threat, whereas the opposite would be true for identity confusion, and (2) that identity confusion exacerbates the association between childhood adversity and threat anticipation. METHODS: One thousand nine hundred and thirteen adolescents from the general population (mean age = 13.8 years, SD = 1.86, range = 11-20) completed self-report questionnaires assessing exposure to childhood adversity, identity development and threat anticipation. RESULTS AND DISCUSSION: Identity development was significantly associated with threat anticipation in the expected direction: identity synthesis was associated with reduced anticipation of threat (ß = -.0013, p < .001), whereas identity confusion was association with increased threat anticipation (ß = .0017, p < .001). Furthermore, childhood adversity was positively associated with threat anticipation (ß = .0018, p < .001). However, no evidence for an interaction effect of identity on the association between childhood adversity and threat anticipation was found, suggesting childhood adversity and identity development have an independent rather than synergistic effect on threat anticipation. CONCLUSION: The current study illustrates the importance of exposure to childhood adversity and identity development for threat anticipation in adolescence. Further research is needed to clarify how both factors influence each other within a developmental framework.

Childhood Adversity and Emerging Psychotic Experiences: A Network Perspective.

BACKGROUND AND HYPOTHESIS: Childhood adversity is associated with a myriad of psychiatric symptoms, including psychotic experiences (PEs), and with multiple psychological processes that may all mediate these associations. STUDY DESIGN: Using a network approach, the present study examined the complex interactions between childhood adversity, PEs, other psychiatric symptoms, and multiple psychological mediators (ie, activity-related and social stress, negative affect, loneliness, threat anticipation, maladaptive cognitive emotion regulation, attachment insecurity) in a general population, adolescent sample (n = 865, age 12-20, 67% female). STUDY RESULTS: Centrality analyses revealed a pivotal role of depression, anxiety, negative affect, and loneliness within the network and a bridging role of threat anticipation between childhood adversity and maladaptive cognitive emotion regulation. By constructing shortest path networks, we found multiple existing paths between different categories of childhood adversity and PEs, with symptoms of general psychopathology (ie, anxiety, hostility, and somatization) as the main connective component. Sensitivity analyses confirmed the robustness and stability of the networks. Longitudinal analysis in a subsample with Wave 2 data (n = 161) further found that variables with higher centrality (ie, depression, negative affect, and loneliness) better predicted follow-up PEs. CONCLUSIONS: Pathways linking childhood adversity to PEs are complex, with multifaceted psychological and symptom-symptom interactions. They underscore the transdiagnostic, heterotypic nature of mental ill-health in young people experiencing PEs, in agreement with current clinical recommendations.

The role of identity in the development of depressive, anxiety, and psychosis symptoms in adolescents exposed to childhood adversity.

INTRODUCTION: Childhood adversity is a major risk factor for psychiatric disorders and has especially been associated with an admixture of depressive, anxiety, and psychosis symptoms. Identity formation, a main developmental task during adolescence, may be impacted by these adverse experiences and act as an important process in the association between childhood adversity and psychopathology. METHODS: We investigated the association between childhood adversity, identity formation, and depressive, anxiety, and psychosis symptoms cross-sectionally in 1913 Flemish adolescents between 11 and 20 years old (mean = 13.76, SD = 1.86). Adolescents completed questionnaires during the first wave of the SIGMA study between January 2018 and May 2019. RESULTS: Childhood interpersonal adversity was associated with increased identity confusion and decreased identity synthesis. Additionally, identity confusion was associated with increased self-reported levels of psychopathology and potentially mediated the association between childhood adversity and psychopathology. CONCLUSION: This study highlights the importance of promoting healthy identity formation in adolescents with and without exposure to adverse childhood experiences.

Coping and sleep quality in youth: An Experience Sampling study.

INTRODUCTION: Sleep quality is closely linked with mental health. Two factors that influence sleep are coping style and locus of control, yet these have not been investigated in daily life. In this study, we examined associations between coping styles and sleep quality in daily life and the potential mediating effect of daily locus of control in a sample of youth, a group particularly vulnerable to developing psychopathology. METHODS: Three hundred and seventy-nine youths from the TwinssCan study participated in an Experience Sampling study, assessing sleep quality as well as state locus of control over the most negative event from the previous day. Participants also completed the Utrecht Coping List, which assessed engagement, disengagement, and emotion-focused coping. RESULTS: Disengagement, "passive reaction," and emotion-focused coping were associated with lower daily sleep quality. State locus of control did not mediate any effects of coping styles on quality of sleep. CONCLUSIONS: Disengagement, "passive reaction," and emotion-focused coping were associated with decreased sleep quality during several consecutive days, which may put youths at risk for developing future insomnia, and strain their mental well-being over time. Thus, there may be value in asking about coping when a young individual presents with sleep problems; however, impaired coping when sleeping poorly should also be considered.

Ecological and Convergent Validity of Experimentally and Dynamically Assessed Capacity for Social Contingency Detection Using the Perceptual Crossing Experiment in Adolescence.

The Perceptual Crossing Experiment (PCE) captures the capacity for social contingency detection using real-time social interaction dynamics but has not been externally validated. We tested ecological and convergent validity of the PCE in a sample of 208 adolescents from the general population, aged 11 to 19 years. We expected associations between PCE performance and (a) quantity and quality of social interaction in daily life, using Experience Sampling Methodology (ESM; ecological validity) and (b) self-reported social skills using a questionnaire (convergent validity). We also expected PCE performance to better explain variance in ESM social measures than self-reported social skills. Multilevel analyses showed that only self-reported social skills were positively associated with social experience of company in daily life. These initial results do not support ecological and convergent validity of the PCE. However, fueled by novel insights regarding the complexity of capturing social dynamics, we identified promising methodological advances for future validation efforts.

The role of threat anticipation in the development of psychopathology in adolescence: findings from the SIGMA Study.

Childhood adversity is associated with psychopathology. First evidence in adults suggests that threat anticipation, i.e., an enhanced anticipation of unpleasant events creating an enduring sense of threat, may be a putative mechanism linking childhood adversity to psychopathology. This study aimed to test the indirect effect of childhood adversity on psychopathology via threat anticipation in a large community sample of adolescents. We measured childhood trauma and bullying victimization (as indicators of childhood adversity), threat anticipation, general psychopathology and prodromal psychotic symptoms in adolescents aged 12-16 years (full sample size N = 1682; minimum sample size in the complete case sample N = 449) in wave I of the SIGMA study. We found strong evidence that childhood adversity (e.g. childhood trauma, adj. ß (aß) = 0.54, p < .001) and threat anticipation (e.g. aß = 0.36, p < .001) were associated with general psychopathology and prodromal psychotic symptoms. Moreover, there was evidence that the association between childhood adversity, general psychopathology and prodromal psychotic symptoms is mediated via pathways through threat anticipation (e.g. childhood trauma, aßindirect effect = 0.13, p < .001). Threat anticipation may be a potential mechanism linking childhood adversity and psychopathology in adolescents.

Lifetime and Current Self-Harm Thoughts and Behaviors and Their Relationship to Parent and Peer Attachment.

Background: Previous research suggests attachment is a vulnerability factor for self-harm thoughts and behaviors in adults. Yet, few studies have investigated this relationship during adolescence, although adolescence is a critical period for changes in attachment relationships and self-harm onset. Whether and how attachment relates to self-harm thoughts and behaviors as measured in daily life is also unknown. Aims: To investigate whether and how paternal, maternal, and peer attachment are associated with lifetime and current adolescent self-harm thoughts and behaviors. Additionally, to examine how different attachment bonds interact in relation to lifetime and current adolescent self-harm thoughts and behaviors. Method: Pre-existing data from N = 1,913 adolescents of the SIGMA study were used. Attachment and lifetime history of self-harm thoughts and behaviors were measured via retrospective questionnaires. Current self-harm thoughts and behaviors were assessed 10 times per day for 6 days using the experience sampling method (ESM). Results: Paternal and maternal attachments were associated with lifetime self-harm thoughts and behaviors and current self-harm thoughts. No significant associations were found between peer attachment and self-harm outcomes. Limitations: Some analyses were underpowered. Conclusion: Our results highlight the importance of parent-child attachment relationships, which may be intervention targets for prevention and treatment of adolescent self-harm.

Designing daily-life research combining experience sampling method with parallel data.

BACKGROUND: Ambulatory monitoring is gaining popularity in mental and somatic health care to capture an individual's wellbeing or treatment course in daily-life. Experience sampling method collects subjective time-series data of patients' experiences, behavior, and context. At the same time, digital devices allow for less intrusive collection of more objective time-series data with higher sampling frequencies and for prolonged sampling periods. We refer to these data as parallel data. Combining these two data types holds the promise to revolutionize health care. However, existing ambulatory monitoring guidelines are too specific to each data type, and lack overall directions on how to effectively combine them. METHODS: Literature and expert opinions were integrated to formulate relevant guiding principles. RESULTS: Experience sampling and parallel data must be approached as one holistic time series right from the start, at the study design stage. The fluctuation pattern and volatility of the different variables of interest must be well understood to ensure that these data are compatible. Data have to be collected and operationalized in a manner that the minimal common denominator is able to answer the research question with regard to temporal and disease severity resolution. Furthermore, recommendations are provided for device selection, data management, and analysis. Open science practices are also highlighted throughout. Finally, we provide a practical checklist with the delineated considerations and an open-source example demonstrating how to apply it. CONCLUSIONS: The provided considerations aim to structure and support researchers as they undertake the new challenges presented by this exciting multidisciplinary research field.

General psychopathology and its social correlates in the daily lives of youth.

BACKGROUND: Adolescence is a period of both great social change, and of vulnerability to psychiatric distress. However, little is known about the associations between early psychopathology and social interactions at the fundamental level of daily life. To better understand the social correlates of subclinical psychopathology in adolescence, we assessed associations between general psychopathology and the quantity and quality of daily-life social interactions. METHODS: During a six-day experience sampling period, adolescent and young adult participants in Study 1 (n = 663) and Study 2 (n = 1027) reported the quantity and quality of their everyday social interactions. General psychopathology was assessed using the Symptom Checklist-90 and Brief Symptom Inventory-53. The relationship between psychopathology and each outcome variable was tested in separate multilevel linear and logistic regression models. RESULTS: General psychopathology was associated with social interaction quality. Associations between psychopathology and the number of social interactions were less apparent: In Study 1, participants with more psychopathology were not more alone, whereas Study 2 participants with higher levels of psychopathology were alone more. LIMITATIONS: Limitations include no separate investigation of distinct types of psychopathology, and relatively low compliance to the experience sampling in Study 2. CONCLUSIONS: Consistent associations between subclinical psychopathology and the quality of social interactions support the fundamentally social nature of early psychopathology. Moreover, negative experiences of social interactions may be more valuable markers of early psychopathology than a reduced quantity of social behaviors. Conceptualizations of daily-life social functioning, and prevention/intervention efforts would benefit from a greater consideration of the quality of everyday social experiences.

Identifying Clusters of Adolescents Based on Their Daily-Life Social Withdrawal Experience.

Social withdrawal is often presented as overall negative, with a focus on loneliness and peer exclusion. However, social withdrawal is also a part of normative adolescent development, which indicates that groups of adolescents potentially experience social withdrawal differently from one another. This study investigated whether different groups of adolescents experienced social withdrawal in daily life as positive versus negative, using experience sampling data from a large-scale study on mental health in general population adolescents aged 11 to 20 (n = 1913, MAge = 13.8, SDAge = 1.9, 63% female) from the Flemish region in Belgium. Two social withdrawal clusters were identified using model-based cluster analysis: one cluster characterized by high levels of positive affect and one cluster characterized by high levels of negative affect, loneliness and exclusion. Logistic regression showed that boys had 66% decreased odds of belonging to the negative cluster. These results show that daily-life social withdrawal experiences are heterogeneous in adolescence, which strengthens the view that, both in research and clinical practice, social withdrawal should not be seen as necessarily maladaptive.

Daily-Life Social Experiences as a Potential Mediator of the Relationship Between Parenting and Psychopathology in Adolescence.

Adolescence is a vulnerable period for psychopathology development, and certain parenting styles are consistent and robust predictors of a broad range of mental health outcomes. The mechanisms through which maladaptive parenting styles affect the development of psychopathology are assumed to be largely social in nature. Yet, the social mechanisms linking parenting to psychopathology are unexplored at arguably the most important level of functioning: daily life. This study aims to identify the associations between three parenting styles, and the experience of daily-life social interactions. Furthermore, we aim to explore the extent to which these parenting styles and altered daily-life social experiences are associated with psychopathology. In this study, we recruited a sample of N = 1,913 adolescents (63.3% girls; mean age = 13.7, age range = 11 to 20) as part of the first wave of the longitudinal cohort study "SIGMA". Parenting styles (psychological control, responsiveness, and autonomy support) and psychopathology symptoms were assessed using a retrospective questionnaire battery. The experienced quality of social interactions in different types of company was assessed using the experience sampling method, ten times per day for 6 days. Direct associations between parenting styles and general quality of daily-life social experiences were tested using a three-level linear model, revealing significant associations between social experiences and different parenting styles. When interaction effects were added to this model, we found that maternal responsiveness and paternal psychological control mainly related to altered qualities of social interactions with parents, while paternal autonomy support was associated with better experiences of non-family social interactions. Finally, an exploratory path analysis highlighted how both paternal autonomy support and altered quality of non-family interactions are uniquely associated with psychopathology levels. These findings demonstrate the general and pervasive effects of maladaptive parenting styles, as parenting seems to broadly affect adolescents' interactions with different types of social partners in everyday life. Moreover, they illustrate a potential mediated relationship in which altered daily-life social interactions could drive the development of psychopathology. A stronger focus may be required on the role of altered day-to-day social experiences in the prevention and potentially, the treatment, of adolescent psychopathology.

The Impact of COVID-19 on Adolescents' Daily Lives: The Role of Parent-Child Relationship Quality.

COVID-19 lockdown measures have profoundly impacted adolescent' daily life, with research suggesting an increase in irritability, stress, loneliness, and family conflict. A potential protective factor is parent-child relationship quality; however, no studies have investigated this. We used data from SIGMA, a longitudinal, experience sampling cohort study, in which N = 173 adolescents aged 11 to 20 were tested before and during COVID-19. Multilevel analyses showed decreased daily-life irritability and increased loneliness from pre- to mid-pandemic. Daily-life stress levels were unchanged. Relationship quality was negatively associated with irritability and loneliness and buffered against the increase in loneliness. Effect sizes were small and do not support a strong effect of the first lockdown on irritability, stress, loneliness, and family conflict in adolescents.

Correlates of physical activity among 142,118 adolescents aged 12-15 years from 48 low- and middle-income countries.

Physical inactivity is a serious public health concern in adolescents from low- and middle-income countries (LMICs). Despite this, only a few multinational studies has investigated correlates of physical activity (PA) in young adolescents in this part of the world. In this study, we identified physical activity correlates using data from the Global school-based Student Health Survey. In total, 142,118 adolescents from 48 LMICs (age 13.8 ±â€¯1.0 years; 49% girls) were included in the analyses. PA was assessed by the PACE+ Adolescent Physical Activity Measure and participants were dichotomised into those who do (60 min of moderate-vigorous PA every day of the week) and do not comply with the World Health Organization recommendations. We used multivariable logistic regression in order to assess the correlates. The prevalence of low PA was 15.3% (95%CI = 14.5%-16.1%). Boys (OR = 1.64; 95%CI = 1.47-1.83) and those who participated in physical education for ≥5 days/week (OR = 1.12; 95%CI = 1.10-1.15) were more likely to meet PA guidelines, while adolescents with food insecurity (OR = 0.85; 95%CI = 0.80-0.90), low fruit and vegetable intake (OR = 0.68; 95%CI = 0.63-0.74), low parental support/monitoring (OR = 0.68; 95%CI = 0.62-0.74), no friends (OR = 0.80; 95%CI = 0.72-0.88), and who experienced bullying (OR = 0.93; 95%CI = 0.86-0.99) were less likely to have adequate levels of PA. There were a few variations in the correlates depending on country-income level. Our data indicate that in adolescents aged 12 to 15 years living in LMICs physical activity participation is a complex and multi-dimensional behavior determined by sociocultural, socio-economic, and policy-related factors. Longitudinal research is needed to confirm/refute the present findings.

Physical fitness and physical activity levels in people with alcohol use disorder versus matched healthy controls: A pilot study.

Low physical fitness and physical inactivity have been recognized as prominent behavioral risk factors for cardiovascular diseases and an independent risk factor for all-cause mortality. To date, no studies have ystematically assessed physical fitness and physical activity in patients with alcohol use disorders (AUD) vs. a healthy comparison group. The aim of this cross-sectional study was to assess and compare the physical fitness and physical activity levels in patients with AUD against healthy controls. Thirty inpatients with AUD (22 males, 40.4 ± 10.5 years, illness duration = 9.7 ± 9.3 years) and 30 age-, gender- and body mass index (BMI)-matched healthy controls were included. All participants performed the Eurofit test battery and the International Physical Activity Questionnaire. Patients also completed the Positive Affect and Negative Affect Scale (PANAS) and Alcohol Use Disorders Identification Test (AUDIT). The PANAS positive and negative scores were 30.1 ± 7.5 and 27.6 ± 8.2; the AUDIT score was 27.3 ± 7.0. Patients with AUD had a reduced whole body balance (flamingo balance test: 12.1 ± 5.1 vs. 8.7 ± 3.9 attempts; p = 0.005), speed of limb movement (plate tapping: 13.3 ± 2.7 vs. 11.6 ± 2.2 s, p = 0.007), explosive leg muscle strength (standing broad jump: 151.8 ± 34.9 vs. 174.2 ± 33.7 cm; p = 0.01), abdominal muscular endurance (sit-ups: 15.9 ± 5.7 vs. 19.8 ± 7.1; p = 0.02), and running speed (shuttle run: 25.4 ± 4.5 vs. 23.1 ± 4.0 s). Patients with AUD were also significantly less physically active than healthy controls (1020.9 ± 578.8 vs. 1738.7 ± 713.3 MET-minutes/week; p < 0.001). Backward regression analyses demonstrated that older age and higher BMI explained lower physical fitness levels, whereas longer illness duration and impaired explosive muscle strength explained lower total physical activity levels. The current findings suggest that lower physical fitness and physical activity are emerging as prominent modifiable risk factors in patients with AUD. Future research should explore the benefits of specific rehabilitation interventions aimed at increasing physical activity and physical fitness in this vulnerable group.

Sedentary behaviour and sleep problems among 42,489 community-dwelling adults in six low- and middle-income countries.

There is a lack of multinational research investigating the association between sleep problems and sedentary behaviour. In this study, we investigated the relationship between the time spent sedentary during waking hours and sleep problems in six low- and middle-income countries. Cross-sectional, community-based data from the Study on Global Ageing and Adult Health survey were analysed. Adjusted logistic regression analyses were undertaken to explore the relationship between self-reported sleep problems (such as difficulties falling asleep, waking up frequently during the night or waking up too early in the morning) in the last 30 days and self-reported sedentary time (categorized as <4, 4 to <8, 8 to <11 or ≥11 hr/day). Among 42,489 individuals aged ≥18 years (mean age=43.8 ± 14.4 years; 50.1% women), those who were sedentary for 8 to <11 hr/day (n = 2,782) and ≥11 hr/day (n = 674) had a 1.61 (95% confidence interval =1.03-2.50) and 1.75 (95% confidence interval =1.17-2.62) times higher odds of having sleep problems, respectively, compared with those being sedentary for less than 4 hr per day (n = 24,637). The strongest associations were observed among those aged 50-64 years. The observed associations were independent of a wide range of sociodemographic factors, physical and mental health conditions and physical activity behaviour. Considering the social and occupational costs of sleep problems, it is important that future longitudinal research should consider the directionality of the data.

Higher cardio-respiratory fitness is associated with increased mental and physical quality of life in people with bipolar disorder: A controlled pilot study.

The aim of this study was to investigate whether cardiorespiratory fitness among outpatients with bipolar disorder is associated with health related quality of life (HRQL) and explore differences versus healthy controls. Outpatients with bipolar disorder and healthy controls matched for age, sex and body mass index completed the 36-item Short Form Health Survey, the Positive-and-Negative-Affect-Schedule (PANAS), a maximal cardiorespiratory fitness test, and wore a Sensewear Armband to measure physical activity and sedentary behavior for eight days. Unpaired t-tests, Pearson correlations and backward regression analyses were performed. Outpatients with bipolar disorder (n = 20; 14♀; 47.9 ± 7.9 years) had a significantly lower physical and mental HRQL than healthy controls (n = 20; 14♀; 47.8 ± 7.6 years), a lower maximum oxygen uptake (VO2max) and were more sedentary. While no significant correlates were found for HRQL in controls, higher VO2max values and lower PANAS negative affect scores predicted better physical and mental HRQL in people with bipolar disorder. The final regression model explained 68% and 58% of the variability in physical and mental HRQL respectively. Cardiorespiratory fitness is associated with mental and physical HRQL among people with bipolar disorder. The current study offers novel targets for scientific investigation and clinical interventions to increase HRQL in people with bipolar disorder.