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.

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.

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.

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.

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.

Momentary Manifestations of Negative Symptoms as Predictors of Clinical Outcomes in People at High Risk for Psychosis: Experience Sampling Study.

BACKGROUND: Negative symptoms occur in individuals at ultrahigh risk (UHR) for psychosis. Although there is evidence that observer ratings of negative symptoms are associated with level of functioning, the predictive value of subjective experience in daily life for individuals at UHR has not been studied yet. OBJECTIVE: This study therefore aims to investigate the predictive value of momentary manifestations of negative symptoms for clinical outcomes in individuals at UHR. METHODS: Experience sampling methodology was used to measure momentary manifestations of negative symptoms (blunted affective experience, lack of social drive, anhedonia, and social anhedonia) in the daily lives of 79 individuals at UHR. Clinical outcomes (level of functioning, illness severity, UHR status, and transition status) were assessed at baseline and at 1- and 2-year follow-ups. RESULTS: Lack of social drive, operationalized as greater experienced pleasantness of being alone, was associated with poorer functioning at the 2-year follow-up (b=-4.62, P=.01). Higher levels of anhedonia were associated with poorer functioning at the 1-year follow-up (b=5.61, P=.02). Higher levels of social anhedonia were associated with poorer functioning (eg, disability subscale: b=6.36, P=.006) and greater illness severity (b=-0.38, P=.045) at the 1-year follow-up. In exploratory analyses, there was evidence that individuals with greater variability of positive affect (used as a measure of blunted affective experience) experienced a shorter time to remission from UHR status at follow-up (hazard ratio=4.93, P=.005). CONCLUSIONS: Targeting negative symptoms in individuals at UHR may help to predict clinical outcomes and may be a promising target for interventions in the early stages of psychosis.

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.

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.

Elucidating negative symptoms in the daily life of individuals in the early stages of psychosis.

BACKGROUND: It remains poorly understood how negative symptoms are experienced in the daily lives of individuals in the early stages of psychosis. We aimed to investigate whether altered affective experience, anhedonia, social anhedonia, and asociality were more pronounced in individuals with an at-risk mental state for psychosis (ARMS) and individuals with first-episode psychosis (FEP) than in controls. METHODS: We used the experience sampling methodology (ESM) to assess negative symptoms, as they occurred in the daily life of 51 individuals with FEP and 46 ARMS, compared with 53 controls. RESULTS: Multilevel linear regression analyses showed no overall evidence for a blunting of affective experience. There was some evidence for anhedonia in FEP but not in ARMS, as shown by a smaller increase of positive affect (BΔat-risk v. FEP = 0.08, p = 0.006) as the pleasantness of activities increased. Against our expectations, no evidence was found for greater social anhedonia in any group. FEP were more often alone (57%) than ARMS (38%) and controls (35%) but appraisals of the social situation did not point to asociality. CONCLUSIONS: Overall, altered affective experience, anhedonia, social anhedonia and asociality seem to play less of a role in the daily life of individuals in the early stages of psychosis than previously assumed. With the experience of affect and pleasure in daily life being largely intact, changing social situations and appraisals thereof should be further investigated to prevent development or deterioration of negative symptoms.

Investigating real-time social interaction in pairs of adolescents with the Perceptual Crossing Experiment.

The study of real-time social interaction provides ecologically valid insight into social behavior. The objective of the current research is to experimentally assess real-time social contingency detection in an adolescent population, using a shortened version of the Perceptual Crossing Experiment (PCE). Pairs of 148 adolescents aged between 12 and 19 were instructed to find each other in a virtual environment interspersed with other objects by interacting with each other using tactile feedback only. Across six rounds, participants demonstrated increasing accuracy in social contingency detection, which was associated with increasing subjective experience of the mutual interaction. Subjective experience was highest in rounds when both participants were simultaneously accurate in detecting each other's presence. The six-round version yielded comparable social contingency detection outcome measures to a ten-round version of the task. The shortened six-round version of the PCE has therefore enabled us to extend the previous findings on social contingency detection in adults to an adolescent population, enabling implementation in prospective research designs to assess the development of social contingency detection over time.

Mindfulness and mood stimulate each other in an upward spiral: a mindful walking intervention using experience sampling.

The aim of this study was to explore the feasibility and effectiveness of mindful walking in nature as a possible means to maintain mindfulness skills after a mindfulness-based cognitive therapy (MBCT) or mindfulness-based stress reduction (MBSR) course. Mindful walking alongside the river Rhine took place for 1, 3, 6, or 10 days, with a control period of a similar number of days, 1 week before the mindful walking period. In 29 mindfulness participants, experience sampling method (ESM) was performed during the control and mindful walking period. Smartphones offered items on positive and negative affect and state mindfulness at random times during the day. Furthermore, self-report questionnaires were administered before and after the control and mindful walking period, assessing depression, anxiety, stress, brooding, and mindfulness skills. ESM data showed that walking resulted in a significant improvement of both mindfulness and positive affect, and that state mindfulness and positive affect prospectively enhanced each other in an upward spiral. The opposite pattern was observed with state mindfulness and negative affect, where increased state mindfulness predicted less negative affect. Exploratory questionnaire data indicated corresponding results, though non-significant due to the small sample size. This is the first time that ESM was used to assess interactions between state mindfulness and momentary affect during a mindfulness intervention of several consecutive days, showing an upward spiral effect. Mindful walking in nature may be an effective way to maintain mindfulness practice and further improve psychological functioning.