Effectiveness of a blended school-based mindfulness program for the prevention of co-rumination and internalizing problems in Dutch secondary school girls: a cluster randomized controlled trial.

BACKGROUND: A growing body of literature indicates that adolescent girls who talk with close friends about interpersonal problems or worries in an excessive, speculative way, and with an intense focus on distress (i.e., co-rumination) are at heightened risk for developing internalizing symptoms and disorders as well as reduced friendship quality. However, to date, there are no prevention programs available that target high levels of co-rumination between adolescent girls. As such, we developed the blended school-based mindfulness prevention program Happy Friends, Positive Minds (HFPM) that targets co-rumination at the dyadic level, i.e., between two close female friends. The aim of this trial is to evaluate the effectiveness of HFPM to reduce co-rumination and internalizing problems and to enhance wellbeing and social-emotional behavior in Dutch adolescent girls. METHODS: A cluster Randomized Controlled Trial (cRCT) will be conducted to evaluate HFPM effectiveness. We will recruit 160 female friendship dyads (n = 320 girls) aged 13 to 15 years who will be characterized by high levels of self-reported co-rumination. The cRCT has two arms: (1) an intervention condition in which 160 girls (80 friendship dyads) will receive the 14-week HFPM program in two consecutive cohorts (cohort 1 in academic year 2023/2024 and cohort 2 in academic year 2024/2025, and (2) a control condition in which 160 girls (80 dyads) will receive care-as-usual (CAU) in two consecutive cohorts (cohort 1 in academic year 2023/2024 and cohort 2 in academic year 2024/2025). Data will be collected at baseline (T0), during the program (T1;T2; T3), immediately after the program (T4), and at 1-year follow-up (T5). Participant-level self-reported risk for (early onset) depression and anxiety, self-reported and observed co-rumination, self- and friend-reported friendship quality, self-reported positive and negative affect, self-reported interpersonal responses to positive affect, and self-reported anhedonia symptoms will be the outcome variables. DISCUSSION: This study will provide insights into the short-term and long-term effects of the HFPM program on girls' internalizing problems, wellbeing, and social-emotional behavior. TRIAL REGISTRATION: International Standard Randomized Controlled Trials, identifier: ISRCTN54246670. Registered on 27 February 2023.

Trajectories of socioeconomic inequality in early child development: a cohort analysis.

BACKGROUND: Addressing socioeconomic inequalities in early child development (ECD) is key to reducing the intergenerational transmission of health inequalities. Yet, little is known about how socioeconomic inequalities in ECD develop over the course of childhood. Our study aimed to describe how inequalities in ECD by maternal education develop from infancy to middle childhood. METHODS: We used data from Generation R, a prospective population-based cohort study in The Netherlands. Language skills were measured at ages 1, 1.5, 2, 3, and 4 years, using the Minnesota Child Development Inventory. Socioemotional (i.e. internalizing and externalizing) problems were measured at ages 1.5, 3, 5 and 9 years using the Child Behavior Checklist. We estimated inequalities in language skills and socioemotional problems across the above-mentioned ages, using linear mixed models with standardized scores at each wave. We used maternal education as indicator of socioeconomic position. RESULTS: Children of less educated mothers had more reported internalizing (B = 0.72, 95%CI = 0.51;0.95) and externalizing (B = 0.25, 95%CI = 0.10;0.40) problems at age 1.5 years, but better (caregiver reported) language skills at 1 year (B = 0.50, 95%CI = 0.36;0.64) than children of high educated mothers. Inequalities in internalizing and externalizing problems decreased over time. Inequalities in language scores reversed at age 2, and by the time children were 4 years old, children of less educated mothers had substantially lower language skills than children of high educated mothers (B = -0.38, 95%CI = -0.61;-0.15). CONCLUSIONS: Trajectories of socioeconomic inequality in ECD differ by developmental domain: whereas inequalities in socioemotional development decreased over time, inequalities increased for language development. Children of less educated mothers are at a language disadvantage even before entering primary education, providing further evidence that early interventions are needed.

Classroom social experiences in early elementary school relate to diurnal cortisol levels.

Social stress has been linked to altered hypothalamic-pituitary-adrenocorticol (HPA) axis activation. During elementary school, children can become exposed to negative peer relations, such as poor appraisal among classroom peers, which is considered a social stressor. However, little is known about the association between classroom peer appraisal and the physiological stress system in children. The goal of this study was to examine the association of peer acceptance and peer non-acceptance with diurnal cortisol concentrations in 222 children from 20 mainstream elementary schools (Mage=6.97years, SD=0.99, 55% boys) in the Netherlands. Saliva samples were collected at awakening, 30min post-awakening, at noon and at 8 pm during a weekend day. From these assessments, the Cortisol Awakening Response (CAR), diurnal cortisol concentration (AUCg) and diurnal cortisol slope were calculated. Peer nominations of peer acceptance (being liked), and peer non-acceptance (being disliked) were collected across a one year interval. Associations were controlled for peer victimization, age, sex and SES and children's levels of emotional problems and behavioural problems. Results showed that low peer acceptance was associated with heightened diurnal cortisol concentration (i.e., heightened AUGg), lower cortisol reductions across the day (i.e., less decreasing cortisol slope) and heightened cortisol awakening response (i.e., heightened CAR). Peer non-acceptance and the interaction between peer acceptance and peer non-acceptance (known as peer rejection) were not associated with AUCg, cortisol slope or the CAR. The findings emphasize the association between poor appraisal among classroom peers and children's heightened HPA-axis activation. This underscores the importance of the physiological stress system in studying the consequences of negative peer relations in children.