Bidirectional Within-Family Effects of Restrictive Mediation Practices and Adolescents' Problematic Social Media Use.

Much remains unknown about whether restrictive mediation is an effective parenting strategy to prevent or reduce problematic social media use among adolescents. Therefore, this study examined bidirectional within-family effects between two restrictive mediation practices (rule-setting and reactive restrictions) and problematic social media use using random-intercept cross-lagged panel modeling. Three-wave survey data collected among Dutch adolescents (T1: N = 1928, Mage = 13.31 years, SD = 0.91, 43.3% girl) with a 1 year-interval were used. Results showed that within-family changes in problematic social media use symptoms predicted subsequent within-family changes in perceived parental restrictive mediation. More specifically, an increase in symptoms predicted a decrease in rule-setting and an increase in reactive restrictions 1 year later. Within-family changes in perceived parental restrictive mediation practices did not predict within-family changes in problematic social media use symptoms, suggesting that the relation is unidirectional. However, concluding that limiting adolescents' Internet use is ineffective to prevent problematic social media use would be premature. Future research should investigate whether it may be an effective parenting strategy for a certain subgroup of adolescents or under certain circumstances.

Process Evaluation and Investigation of Cultural Adaptations for an Online Parent-Based Intervention Using a Mixed-Method Approach.

Most alcohol intervention research focuses on program efficacy, yet few studies have investigated the acceptability of a program's design and implementation to the target population or adapting existing alcohol interventions to different populations. To address these gaps in the literature, we (1) examined participant responsiveness to and implementation quality of FITSTART+, a web-app delivered parent-based alcohol intervention designed for incoming first-year college students in the United States, and (2) gathered feedback on how this intervention could be adapted to other populations of parents. A sample of U.S. parents of 17-20-year-old first-year college students (N = 109) participated in FITSTART+ during their child's first year of college and completed a survey about parents' responsiveness to the app and its quality. Next, a sample of non-U.S. parents of adolescents aged 13 to 19 (N = 44) participated in one of 11 focus groups in which they briefly explored the app and then discussed how it could be adapted to be applicable and culturally relevant for them and their context. Results revealed that U.S. parents rated the intervention's quality as high and parents were responsive to the web-app's content, but some did not visit one of the most critical aspects of the intervention (i.e., alcohol-related parenting resources). Non-U.S. participants provided a range of suggestions for adapting the intervention to their context, which varied by culture. Results identify areas for improvement, particularly regarding the use of alcohol-related parenting resources, in this intervention and for web-delivered PBIs more broadly.

Predicting Adolescents' Problematic Social Media Use From Profiles of Internet-Specific Parenting Practices and General Parenting Dimensions.

Although both Internet-specific and general parenting have been linked to adolescents' problematic social media use, until now they have been investigated as separate predictors of this behavior. As specific parenting practices occur in the broader general parenting context, this study examined how different Internet-specific parenting practices (Internet-specific rule setting, reactive restrictions towards Internet use, and co-use) and general parenting dimensions (responsiveness and autonomy-granting) co-occur, and act together in predicting adolescents' problematic social media use. Four-wave data of 400 adolescents (T1: M age = 13.51 years, SD = 2.15, 54% girls) were used. Latent profile analysis identified three parenting profiles: Limiting and less supportive (13.5%), Tolerant and supportive (25.5%), and Limiting and supportive (60.8%). Membership to Tolerant and supportive predicted lower scores on prospective problematic social media use than membership to the other profiles. Besides, membership to Limiting and supportive predicted lower scores on problematic social media use than membership to Limiting and less supportive. No robust moderation effects of adolescents' age and gender were found. These findings suggest that a supportive general parenting context rather than Internet use restrictions should be the focus when considering the prevention of adolescents' problematic social media use.

How Specific is Alcohol-Specific Self-Control? A Longitudinal Study of the Mediating Role of Alcohol-Specific Self-Control in the Relation Between General Self-Control and Adolescent Alcohol Use.

Although accumulating studies indicate that alcohol-specific self-control can be useful in predicting adolescent alcohol use, little is known about its specificity. This longitudinal study aimed to advance our understanding of domain-specific self-control by examining whether alcohol-specific self-control mediates the effect of general self-control on adolescent alcohol use or has generalizing effects by also mediating the effect of general self-control on other behavior requiring self-control (adolescent digital media use and smoking). Data from 906 adolescents aged 11-14 years who were enrolled in the Dutch study Prevention of Alcohol Use in Students were used. Data were collected using online questionnaires at four annual measurements. Structural equation modelling revealed that higher alcohol-specific self-control fully mediated the effect of higher general self-control on alcohol use. Alcohol-specific self-control did not mediate the effect of higher general self-control on digital media use, but did partially mediate the effect of higher general self-control on smoking. These results suggest that alcohol-specific self-control is domain-specific, but not necessarily substance-specific. The domain-specificity of alcohol-specific self-control provides evidence for its theoretical relevance for the explanation of adolescent alcohol use. It also suggests leverage points for intervention programs focusing on improving alcohol-specific self-control to reduce adolescent alcohol use.

Causal mediation analysis: From simple to more robust strategies for estimation of marginal natural (in)direct effects.

This paper aims to provide practitioners of causal mediation analysis with a better understanding of estimation options. We take as inputs two familiar strategies (weighting and model-based prediction) and a simple way of combining them (weighted models), and show how a range of estimators can be generated, with different modeling requirements and robustness properties. The primary goal is to help build intuitive appreciation for robust estimation that is conducive to sound practice. We do this by visualizing the target estimand and the estimation strategies. A second goal is to provide a "menu" of estimators that practitioners can choose from for the estimation of marginal natural (in)direct effects. The estimators generated from this exercise include some that coincide or are similar to existing estimators and others that have not previously appeared in the literature. We note several different ways to estimate the weights for cross-world weighting based on three expressions of the weighting function, including one that is novel; and show how to check the resulting covariate and mediator balance. We use a random continuous weights bootstrap to obtain confidence intervals, and also derive general asymptotic variance formulas for the estimators. The estimators are illustrated using data from an adolescent alcohol use prevention study. R-code is provided.

Examination of risk exposure models during COVID-19 in relation to youth life satisfaction and internalizing symptoms.

This study examined mediation of a negative COVID-impact on the relationship between risk exposure, and life satisfaction and internalizing symptoms in youth (aged 9-18). Four operationalizations of risk exposure were applied; an Additive versus a Cumulative Risk Model (ARM and CRM), risk clusters and the most salient risk factors. Results showed that a stronger negative COVID-impact is related to lower life satisfaction, more internalizing symptoms and higher additive and cumulative risk. ARM and CRM's effect on lower life satisfaction is mediated through negative COVID-impact, though not for internalizing symptoms. Clusters of risk factors and risk factors within clusters significantly related to a stronger negative COVID-impact are the clusters 'Individual factors' (low self-control), 'Parenting' (negative mother-child interaction and low parental responsiveness), 'Maternal mental health' and 'Demographic factors' (low SES and high paternal education). From all significant risk factors, low self-control, low parental responsiveness, negative mother-child interaction and low SES were most salient.

Rules, role models or overall climate at home? Relative associations of different family aspects with adolescents' problematic social media use.

AIM: This study aimed to enhance knowledge on which aspects of the family context are most relevant in identifying at-risk/problematic social media users among adolescents. Therefore, we examined the relative contribution to adolescents' at-risk/problematic social media use (SMU) of general and Internet-specific family factors related to three different family (sub)systems: parent-child (Internet-specific rule-setting, reactive restrictions towards Internet use, co-use, adolescents' involvement in rule-setting and positive parenting), parent (parental screen time, phubbing, stress, anxiety and depression) and family (family functioning, family intactness and SES) (sub)system. METHODS: Questionnaire data came from 403 adolescents (M = 13.51, SD = 2.15) and 396 parents (M = 46.59, SD = 5.29) who participated in wave 1 of the Dutch 'Digital Family project'. RESULTS: Logistic regression analyses showed that only factors related to the parent-child subsystem remained significant in predicting being an at-risk/problematic social media user when examining predictors related to the parent-child, parent and family (sub)system simultaneously. Specifically, general and Internet-specific parenting practices contributed to the prediction above and beyond each other. Positive parenting and Internet-specific rule-setting seem protective, while parental reactive restrictions towards Internet use could be a risk factor. Positive parenting showed the largest effect size. CONCLUSION: The results suggest that parental behaviors directed towards the child should be a focus of attention in prevention of adolescents' problematic SMU. In addition, our findings highlight the importance of untangling restrictive mediation (impulsive, in the moment, attempts to limit SMU versus communicating clear rules in advance) when examining its effects.

Youth Sensitivity in a Pandemic: The Relationship Between Sensory Processing Sensitivity, Internalizing Problems, COVID-19 and Parenting.

The personality trait sensory processing sensitivity (SPS) is an established risk factor for the development of internalizing problems. Highly sensitive adolescents react stronger to environmental cues including parenting environment and stressful life events. The aim of the current study was to examine if the perceived impact of COVID-19, mediates the link between SPS and internalizing problems. In addition, it was tested if parenting style moderates the mediating effect of perceived COVID-19 impact between SPS and internalizing problems among adolescents. The study had a cross- sectional design and data were collected between April-July 2020 during the first lockdown in the Netherlands. Participants were 404 adolescents aged 9-18 years (Mage = 13.49). Questionnaires were administered online to assess SPS (Highly Sensitive Child Scale), parenting style (Parenting Style Inventory-II), internalizing problems (Patient Health Questionnaire-4) and COVID-19 pandemic impact (COVID-19 impact scale). The SPSS macro PROCESS was used to test the mediation model of perceived COVID-19 impact and the moderated mediation model with parenting style as a moderator. A relationship was found between SPS and internalizing problems which is partly mediated by the COVID-19 impact. The moderating effect of parenting style was not found. These findings provide insight into the effect the pandemic has had on highly sensitive adolescents. Further research is needed to develop and test interventions to support sensitive youth and thus possibly prevent the development of internalizing problems.

A Qualitative Study on Children's Digital Media Use and Parents' Self-interest.

This qualitative study provides insight into the role of parents' self-interest in digital media use of children in different age groups. We conducted 31 semi-structured interviews with fathers/mothers of children aged 3-16 years who were recruited via targeted sampling. A deductive and inductive content analysis was applied. Results show that parents' self-interest in letting children use digital media includes being able to do other tasks without being bothered, having some me-time, managing children's behavior, avoiding discussions, having moments to use digital media themselves and spending quality-time together. In addition, we found that the manner in which parents let children use digital media out of self-interest seems to depend on age. With younger children, parents initiate digital media use or set times at which children are allowed to use digital media. With older children, parents use a passive manner by omitting restrictive responses to their children's media use. Current findings can be used to inform interventions aimed at reducing children's screen time.

Validation of the Social Media Disorder Scale in Adolescents: Findings From a Large-Scale Nationally Representative Sample.

Large-scale validation research on instruments measuring problematic social media use (SMU) is scarce. Using a nationally representative sample of 6,626 Dutch adolescents aged 12 to 16 years, the present study examined the psychometric properties of the nine-item Social Media Disorder scale. The structural validity was solid, because one underlying factor was identified, with adequate factor loadings. The internal consistency was good, but the test information was most reliable at moderate to high scores on the scale's continuum. The factor structure was measurement invariant across different subpopulations. Three subgroups were identified, distinguished by low, medium, and high probabilities of endorsing the criteria. Higher levels of problematic SMU were associated with higher probabilities of mental, school, and sleep problems, confirming adequate criterion validity. Girls, lower educated adolescents, 15-year-olds, and non-Western adolescents were most likely to report problematic SMU. Given its good psychometric properties, the scale is suitable for research on problematic SMU among adolescents.

Pre-Intervention Effects of a Community-Based Intervention Targeting Alcohol Use (LEF); The Role of Participatory Research and Publicity.

This study explores the impact of the 'pre-intervention effects' of a community-based intervention. This refers to participatory research processes and parallel publicity in the media on changes in alcohol use and relevant mechanisms (rules and norms about alcohol, accessibility of alcohol in a formal setting) among adolescents before any intervention is implemented. The aim was to investigate the contribution of these processes (i.e., pre-intervention effects) to changes in intervention-targeted factors before any actual intervention was implemented. In a quasi-experimental study, data were collected twice by means of self-report among adolescents living in two municipalities (control and experimental condition). A regression analysis showed negative pre-intervention main effects on adolescents' perceived accessibility of alcohol in a formal setting. Moreover, among adolescents aged 15 years and older, the normative decline in strictness of rules and norms was less steep in the experimental condition compared to the control condition. Additionally, adolescents aged 14 years and younger in the experimental condition reported more weekly drinking compared to their peers in the control condition. No differential effects across gender were found. To conclude, applying a co-creational approach in the development of an intervention not only contributes to more effective interventions in the end, but the involvement of and discussions in the community when planning the intervention contribute to changes in targeted factors. This implies that public discussions about the development of intervention strategies should be considered as an essential feature of co-creation in community-based interventions.

Exploratory and confirmatory factor analysis of the parental rules toward adolescent drinking questionnaire: Two factors are better than the original one.

The parental rules toward drinking questionnaire (PRQ; Van der Vorst et al., 2005) assesses strictness toward adolescent drinking situations. The aim of the current study was to address a gap in the literature on the psychometric testing and evaluation of the factor structure of the PRQ. The current sample consisted of Dutch adolescents (N = 2922) who participated in a randomized control trial with three intervention groups (parent, student, and parent + student) and a control. PRQ and frequency of alcohol use (past month and year) were measured at baseline (T1) and 12 months later (T2). Results from Exploratory and Confirmatory Factor Analyses revealed two reliable factors: (a) rules about normative drinking situations and (b) rules about non-normative drinking situations (both αs ≥ 0.88). Regression analyses conducted to examine the prospective effects of the interventions revealed that both parent conditions predicted increases in strictness toward normative drinking situations relative to the control condition, while only the parent + student condition affected the original PRQ (single factor). Further, the normative subscale predicted increases in drinking (past month and year), as did the original PRQ. Significant effects with the normative subscale indicate that rules toward these drinking situations are ones that account for the effects in the original PRQ, and that the original PRQ can mask effects. The results illustrate that the PRQ is multidimensional. The effects of the normative subscale suggest that intervention efforts should focus on preventing drinking situations that parents normally permit their adolescents to engage in.

Social Media Use and Adolescents' Sleep: A Longitudinal Study on the Protective Role of Parental Rules Regarding Internet Use before Sleep.

The popularity of social media use among adolescents has raised concerns about the potentially harmful effects of social media use on adolescents' sleep. Since longitudinal research considering this relationship is scarce, the present two-wave longitudinal study of 2021 secondary school students (Mage = 13.86, SD = 1.25) examined whether frequency of social media use and problematic social media use predicted adolescents' bedtime and quality of sleep. Moreover, the protective role of parental rules regarding Internet and smartphone use one hour before sleep was examined. The findings indicated that strict parental rules about Internet and smartphone use before sleep might prevent negative consequences of social media use on bedtime and sleep quality, but only among less engaged social media users. Once adolescents are highly engaged social media users, strict parental rules do not seem to prevent negative media influences on sleep. This implies that limiting Internet accessibility before bedtime can help prevent adolescents' sleep problems, but that regulation is less effective for adolescents who are already highly involved in social media use.

A framework for assessing neuropsychiatric phenotypes by using smartphone-based location data.

The use of smartphone-based location data to quantify behavior longitudinally and passively is rapidly gaining traction in neuropsychiatric research. However, a standardized and validated preprocessing framework for deriving behavioral phenotypes from smartphone-based location data is currently lacking. Here, we present a preprocessing framework consisting of methods that are validated in the context of geospatial data. This framework aims to generate context-enriched location data by identifying stationary, non-stationary, and recurrent stationary states in movement patterns. Subsequently, this context-enriched data is used to derive a series of behavioral phenotypes that are related to movement. By using smartphone-based location data collected from 245 subjects, including patients with schizophrenia, we show that the proposed framework is effective and accurate in generating context-enriched location data. This data was subsequently used to derive behavioral readouts that were sensitive in detecting behavioral nuances related to schizophrenia and aging, such as the time spent at home and the number of unique places visited. Overall, our results indicate that the proposed framework reliably preprocesses raw smartphone-based location data in such a manner that relevant behavioral phenotypes of interest can be derived.

Bidirectional effects of Internet-specific parenting practices and compulsive social media and Internet game use.

INTRODUCTION: This two-wave prospective study investigated the bidirectional relation between Internet-specific parenting (reactive restrictions, Internet-specific rules, and frequency and quality of communication about Internet) and adolescents' symptoms of social media disorder (SMD) and Internet gaming disorder (IGD). In addition, we investigated whether this relation was different for boys and girls. METHODS: A sample of 352 adolescents (48.9% boys, Mage = 13.9, SDage = 0.74, range: 11-15) completed questionnaires at two waves. Zero-inflated cross-lagged analyses in Mplus were performed to predict the level of IGD and SMD symptoms by Internet-specific parenting practices and vice versa, while controlling for age, level of education, and outcome at T1. RESULTS: More frequent parent-adolescent communication about Internet predicted more IGD (ß = 0.26, p = .03) and SMD symptoms among boys, and more restrictive rules predicted fewer SMD symptoms among girls (ß = -0.23, p = .08). More IGD symptoms predicted more reactive rules (ß = 0.20, p = .08) among boys and girls and a higher frequency (ß = 0.16, p = .02) and lower quality of communication (ß = -0.24, p < .001) among boys and girls, respectively. CONCLUSIONS: This study demonstrates bidirectional relations between Internet-specific parenting and IGD symptoms, but not SMD symptoms. Displaying IGD symptoms seems to elicit ineffective parental responses, which may further exacerbate problematic involvement in gaming. With respect to problematic social use media among girls, this study suggests that parents should set strict rules regarding Internet use, prior to problematic use of social media. Longitudinal studies on the role of parenting in development of Internet-related disorders would be promising in enhancing our understanding of how parents can effectively prevent problematic involvement in online behaviors among their children.

Secondary Effects of an Alcohol Prevention Program Targeting Students and/or Parents.

The secondary effects of an alcohol prevention program (PAS) on onset of weekly smoking and monthly cannabis use are examined among >3000 Dutch early adolescents (M age=12.64) randomized over four conditions: 1) parent intervention (PI), 2) student intervention (SI), 3) combined intervention (CI) and 4) control condition (CC). Rules about alcohol, alcohol use, and adolescents' self-control were investigated as possible mediators. PI had a marginal aversive effect, slightly increasing the risk of beginning to smoke at T1, and increased the likelihood of beginning to use cannabis use at T1 and T2. SI delayed the onset of monthly cannabis use at T3. CI increased the risk to use cannabis at T3. No mediational processes were found. In conclusion, though this study show mixed results, negative side effects of the PI were found, particularly at earlier ages. Moreover, these results indicate the need for multi-target interventions.

Causal mediation analysis with a binary outcome and multiple continuous or ordinal mediators: Simulations and application to an alcohol intervention.

We investigate a method to estimate the combined effect of multiple continuous/ordinal mediators on a binary outcome: 1) fit a structural equation model with probit link for the outcome and identity/probit link for continuous/ordinal mediators, 2) predict potential outcome probabilities, and 3) compute natural direct and indirect effects. Step 2 involves rescaling the latent continuous variable underlying the outcome to address residual mediator variance/covariance. We evaluate the estimation of risk-difference- and risk-ratio-based effects (RDs, RRs) using the ML, WLSMV and Bayes estimators in Mplus. Across most variations in path-coefficient and mediator-residual-correlation signs and strengths, and confounding situations investigated, the method performs well with all estimators, but favors ML/WLSMV for RDs with continuous mediators, and Bayes for RRs with ordinal mediators. Bayes outperforms WLSMV/ML regardless of mediator type when estimating RRs with small potential outcome probabilities and in two other special cases. An adolescent alcohol prevention study is used for illustration.

The Outcomes of an Alcohol Prevention Program on Parents' Rule Setting and Self-efficacy: a Bidirectional Model.

Most adolescents have their first encounter with alcohol in early or middle adolescence. Parents' rule setting about alcohol has been shown to be important to delay the onset and reduce the frequency of adolescents' alcohol drinking, but less is known about the potential role of parents' beliefs about their competence in and ability to influence their adolescents' drinking habits (i.e., parental self-efficacy [PSE], Bandura (Psychological Review, 84, 191-215, 1977). In this study, we examined the direction of influence between parents' rule setting and PSE as outcomes of the program "Prevention of Alcohol use in Students" (PAS), a prevention program aiming to reduce underage drinking by targeting parents and adolescents both separately and in a combined intervention. We tested two mediation processes in which the program would (a) have a direct effect on PSE, which in turn would increase parents' rule setting or (b) have a direct effect on parents' rule setting, which in turn would increase PSE. To examine these processes, we used a sample of 2562 parent-adolescent dyads (age 12 at baseline), followed annually over 3 years. The results showed that the combined intervention increased PSE via an increase in parents' rule setting. No significant effect of the intervention on rules about alcohol via PSE was found. This is the first study to test the mediation processes involving PSE and parental rule setting in an experimental context where parenting practices are being actively changed. The results suggest that giving parents concrete advice on how to deal with alcohol drinking in their adolescents and at the same time helping adolescents to develop healthy attitudes about alcohol drinking have a positive influence on parents' self-efficacy.

The Reciprocal Relation Between Adolescents' School Engagement and Alcohol Consumption, and the Role of Parental Support.

While school engagement and the use of alcohol are subject to change during the course of adolescence, studies have shown that being engaged in school equates with a later onset of alcohol consumption. Cross-sectional studies also indicate that alcohol use correlates to school engagement, but the reciprocal nature of these factors has never been investigated. This study examines the reciprocal relation between school engagement and alcohol consumption during adolescence. Further, the moderating effect of perceived parental support in this reciprocal relation between school engagement and alcohol consumption is tested. Data were obtained from Dutch high school students (n = 906, 52.5% boys, mean age = 12.19 years) who annually completed a digital questionnaire over 4 years (age 12 to 15). A cross-lagged autoregressive model was applied in AMOS. Results showed that more school engagement at ages 12 and 14 predicted lower levels of alcohol use 1 year later. In addition, more alcohol consumption at ages 12 and 14 predicted lower levels of school engagement 1 year later. Higher school engagement at age 13 predicted less alcohol use at age 14, whereas no significant effect of alcohol use on school engagement was found at this age period. Furthermore, a reciprocal relation was found only for adolescents who perceived high parental support. The reciprocal nature of school engagement and alcohol consumption should be a consideration in future research and prevention program development.

Effects of a combined parent-student alcohol prevention program on intermediate factors and adolescents' drinking behavior: A sequential mediation model.

OBJECTIVE: Previous work revealed that the combined parent-student alcohol prevention program (PAS) effectively postponed alcohol initiation through its hypothesized intermediate factors: increase in strict parental rule setting and adolescents' self-control (Koning, van den Eijnden, Verdurmen, Engels, & Vollebergh, 2011). This study examines whether the parental strictness precedes an increase in adolescents' self-control by testing a sequential mediation model. METHODS: A cluster randomized trial including 3,245 Dutch early adolescents (M age = 12.68, SD = 0.50) and their parents randomized over 4 conditions: (1) parent intervention, (2) student intervention, (3) combined intervention, and (4) control group. Outcome measure was amount of weekly drinking measured at age 12 to 15; baseline assessment (T0) and 3 follow-up assessments (T1-T3). RESULTS: Main effects of the combined and parent intervention on weekly drinking at T3 were found. The effect of the combined intervention on weekly drinking (T3) was mediated via an increase in strict rule setting (T1) and adolescents' subsequent self-control (T2). In addition, the indirect effect of the combined intervention via rule setting (T1) was significant. No reciprocal sequential mediation (self-control at T1 prior to rules at T2) was found. CONCLUSIONS: The current study is 1 of the few studies reporting sequential mediation effects of youth intervention outcomes. It underscores the need of involving parents in youth alcohol prevention programs, and the need to target both parents and adolescents, so that change in parents' behavior enables change in their offspring.