Perceived life threat in children during the COVID-19 pandemic: associations with posttraumatic stress, anxiety, and depressive symptoms.

Defining children's "trauma exposure" in the context of the COVID-19 pandemic has been a source of debate. Children were exposed to threatening messaging about COVID-19 but might interpret this information differently than adults. Perceived life threat (PLT), the belief that one's life is in danger, has been identified as a robust predictor of posttraumatic stress symptoms (PTSS), and may be a better predictor of PTSS than actual life threat (ALT). This study investigated parent reports of children's self-PLT (belief that they might die from COVID-19) and family-PLT (belief that a family member might die from COVID-19). The aims were to compare PLT to ALT, evaluate their associations with children's psychological functioning, and identify risk factors associated with PLT. We hypothesized an association between PLT and children's psychological functioning in the context of the COVID-19 pandemic. Parents (N = 140) reported on their child's (M age = 9.81 years, 47% female) pandemic experiences, psychological functioning, and both self-PLT and family-PLT. Results revealed self-PLT for 10% of the children and family-PLT for 43% of the children, yet only 6% experienced ALT (i.e., they or their parent tested positive for COVID-19). Children with reported self- or family-PLT had higher PTSS, depressive symptoms, anxiety symptoms, and functional impairment compared to children without these reported beliefs. PLT, but not ALT, was associated with psychological outcomes. Children with only PLT had greater PTSS and impairment than children with ALT. There were differences in parental functioning and pandemic-related information/media exposure between children with and without PLT. Children's perceptions, rather than objective experiences, may be more central to their psychological functioning. This has implications for screening for pandemic-related symptomatology in children as traditional trauma exposure measures may not adequately identify distressed children.

Parental unemployment and educational outcomes in late adolescence: the importance of family cohesion, parental education, and family income in a Norwegian study.

AIMS: The study aimed to investigate the association between parental unemployment and grade point average and school completion in adolescence, and the importance of family cohesion, parental education, and family income in explaining these associations. METHODS: Data stem from the Norwegian cross-sectional 2012 youth@hordaland-survey including 8437 adolescents (53.4% girls). Information on grade point average, school completion, parental education, and family income were retrieved from the National Education Database. Parental work status and family cohesion were assessed by adolescent self-report. RESULTS: Adolescents with at least one unemployed parent had lower grade point averages (3.49 compared with 3.92, P<0.001) and rates of school completion (71.9% compared with 86.6%, P<0.001) compared with adolescents with two working parents. The associations between parental unemployment and both grade point average (b = -0.22, 95% confidence interval -0.32, -0.12) and school completion (odds ratio 0.59, 95% confidence interval 0.46, 0.76) partly attenuated but remained significant when taking family cohesion, parental education, and family income into account. There was a significant interaction between parental unemployment and family cohesion on grade point average, in which the positive association between family cohesion and grade point average was weaker for adolescents with unemployed parents. CONCLUSIONS: Adolescents with parents outside of the workforce are at higher risk of poorer educational outcomes than peers with working parents. Combined with the positive associations between parental education, family cohesion, family income, and educational outcomes, this underscores the importance of parents for adolescent educational outcomes, and suggests that parents and the family situation should be considered when providing academic support for adolescents who struggle in upper secondary school.

Diabetes Care and Mental Health During the COVID-19 Pandemic: Perspectives of Adolescents with Diabetes, Parents, and Providers.

This study explored ways in which the COVID-19 pandemic impacted adolescents' diabetes management and psychosocial functioning, and how adolescents, parents, and providers viewed telemedicine. We present data from three studies: (1) a comparison of psychosocial functioning and glycemic levels before and after pandemic onset (n = 120 adolescents; 89% with type 1 diabetes), (2) an online survey of parents about pandemic-related stressors (n = 141), and (3) qualitative interviews with adolescents, parents, and medical providers about the pandemic's impacts on adolescents' diabetes care and mental health (n = 13 parent-adolescent dyads; 7 medical providers). Results suggested some adverse effects, including disrupting routines related to health behaviors and psychosocial functioning and impairing adolescents' quality of life. Despite these challenges, most participants did not endorse significant impacts. Some even noted benefits, such as increased parental supervision of diabetes management that can be leveraged beyond the pandemic. Furthermore, telemedicine offers benefits to continuity of diabetes care but presents challenges to care quality. These findings underscore the varied and unique impacts of the COVID-19 pandemic on adolescents with diabetes.

A bibliometric analysis on adolescent social anxiety and psychoeducational variables in Web of Science 2002-2021.

The aim of this bibliometric analysis was to analyze the scientific output on adolescent social anxiety and its relationship with 15 psychoeducational variables in peer-reviewed journals during the period 2002-2021. The goal was to provide a comprehensive overview of the state of the art on adolescent social anxiety and academic/school achievement, performance, self-concept, self-esteem, self-efficacy, self-attributions, goals, attachment, adjustment, engagement, refusal, absenteeism, anxiety, learning strategies, and self-regulated learning. A search of scientific literature was conducted using Web of Science, and 157 empirical studies were identified. Analyses were conducted using bibliometrix 3.1 to avoid the risk of bias. The results suggested progressive growth in the scientific output on this research topic mainly in the USA, China, Spain, and Canada, and revealed trending issues and scientific interest regarding the relationship between adolescent social anxiety and academic/school achievement and performance. Other variables, such as academic/school attachment and self-regulated learning did not emerge. The results provide implications for practitioners (i.e., educators, clinical and educational psychologists, and psychiatrists), supporting emerging lines of research. Limitations include a lack of a review protocol and a lack of comparison with other international databases, such as PsychInfo, Scopus, PubMed, or ERIC.

Climate change and extreme weather disasters: evacuation stress is associated with youths' somatic complaints.

Objective: Climate-change has brought about more frequent extreme-weather events (e.g., hurricanes, floods, and wildfires) that may require families to evacuate, without knowing precisely where and when the potential disaster will strike. Recent research indicates that evacuation is stressful for families and is associated with psychological distress. Yet, little is known about the potential impact of evacuation stressors on child health. After Hurricane Irma, which led to a mass evacuation in Florida, we examined whether evacuation stressors and hurricane exposure were uniquely associated with youth somatic complaints, and whether youth psychological distress (i.e., symptoms of posttraumatic stress, anxiety, and depression) served as a potential mediating pathway between evacuation stressors, hurricane experiences, and somatic complaints. Method: Three months after Irma, 226 mothers of youth aged 7-17 years (N=226; M age = 9.76 years; 52% boys; 31% Hispanic) living in the five southernmost Florida counties reported on evacuation stressors, hurricane-related life threat and loss/disruption, and their child's psychological distress and somatic complaints using standardized measures. Results: Structural equation modeling revealed a good model fit (χ2 = 32.24, p = 0.003, CFI = 0.96, RMSEA = 0.08, SRMR = 0.04). Even controlling for life-threatening hurricane experiences (ß = 0.26) and hurricane loss and disruption (ß = 0.26), greater evacuation stressors were associated with greater symptoms of youth psychological distress (ß = 0.34; p's < 0.001), and greater psychological distress was associated with more somatic complaints (ß = 0.67; p < 0.001). Indirect effects revealed that evacuation stressors (p < 0.001), actual life-threatening events (p < 0.01), and loss and disruption (p < 0.01) were all uniquely and indirectly associated with youths' somatic complaints via youth psychological distress. Discussion: Findings suggest that even coping with the threat of a disaster may be sufficient to prompt psychological and physical health symptoms in youth. Due in part to climate change, threats of disaster occur much more often than actual disaster exposure, especially for areas that are prone to hurricanes or wildfires. Preparing youth and families residing in vulnerable areas for potential disaster evacuation or sheltering-in-place appears critical. Encouraging families to develop Disaster Plans and teaching stress management skills may reduce both youth distress and somatic health problems.

Does age matter in genetics? The role of ADCYAP1R1 in sex-specific risk for posttraumatic stress disorder in trauma-exposed preadolescent children.

Following trauma exposure, children are a vulnerable population and at risk for developing posttraumatic stress disorder (PTSD). A large body of research has demonstrated the impactful role of genetics in vulnerability for PTSD in adult samples; yet very little research has examined genetic risk for PTSD in children. It is unknown whether genetic associations identified in adults are true for children; replication of findings from adult samples is needed in child samples. This study investigated an estrogen-responsive variant (ADCYAP1R1) that has been well-established to confer sex-specific risk for PTSD in adult samples, but is hypothesized to function differently in children, potentially due to pubertal changes in the estrogen system. Participants were children (n = 87; 57% female) ages 7 to 11 exposed to a natural disaster. Participants were assessed for trauma exposure and symptoms of PTSD. Participants provided a saliva sample, which was genotyped for the ADCYAP1R1 rs2267735 variant. In girls, the ADCYAP1R1 CC genotype was associated with PTSD (OR = 7.30). In boys, evidence for the opposite effect emerged, with the CC genotype attenuating risk for PTSD (OR = 8.25). When investigating specific PTSD symptom clusters, an association between ADCYAP1R1 and arousal emerged. This study is the first to investigate the relationship between ADCYAP1R1 and PTSD in trauma-exposed children. Findings for girls mirrored prior research on adult women, whereas findings for boys diverged from prior research on adult men. These potential differences between children and adults in genetic vulnerability for PTSD underscore the need for more genetic studies in child samples.

Patient and Provider Views on Psychosocial Screening in a Comprehensive Diabetes Center.

Guidelines recommend routinely screening adults with diabetes for psychological concerns, but few diabetes clinics have adopted screening procedures. This study assessed patient and provider perspectives regarding the role of mental health in diabetes care, psychosocial screening procedures, and patients' support needs. Patients with diabetes (n = 15; 73.3% type 2) and their medical providers (n = 11) participated in qualitative interviews. Thematic content analysis was used to categorize results. Participants believed that mental health was important to address within comprehensive diabetes care. Patients expressed positive or neutral opinions about psychosocial screening. Providers had mixed reactions; many thought that screening would be too time-consuming. Both groups emphasized that screening must include referral procedures to direct patients to mental health services. Patients and providers interviewed in this study viewed psychosocial screening as compatible with diabetes care. Including a mental health professional on the treatment team could reduce potential burden on other team members.

Psychosocial screening in a pediatric diabetes clinic: Adolescents' and mothers' perspectives.

OBJECTIVE: Adolescents with type 1 diabetes (T1D) frequently experience psychosocial concerns, and mental health screening is becoming increasingly common in routine diabetes care. However, little is known about what adolescents or their caregivers think about the role of mental health screening and intervention within the context of comprehensive diabetes care, or how their diabetes care providers should be involved in navigating mental health concerns. This study used qualitative methods to obtain the perspectives of adolescents with T1D and their caregivers regarding these issues. METHODS: Participants were 13 adolescents with T1D (ages 12-19 years; M = 15.1 years; 53.8% female; 61.5% Hispanic/Latinx White) and 13 mothers, recruited from an outpatient pediatric endocrinology clinic in South Florida, who participated in semi-structured interviews via video teleconference. Thematic content analysis was used to evaluate participants' responses. RESULTS: Adolescents and their mothers reported positive experiences with the clinic's psychosocial screening procedures and appreciated meeting with the psychology team during visits. They wanted the clinic to offer more opportunities for peer support. Mothers highlighted barriers to seeking mental health care outside of the clinic and the importance of mental health professionals understanding diabetes. Mothers also wanted the clinic to offer more on-site therapeutic services. DISCUSSION: Study participants valued psychosocial screening and supported addressing mental health as a routine part of diabetes comprehensive care.

Evacuation- and hurricane-related experiences, emotional distress, and their associations with mothers' health risk behaviors.

OBJECTIVE: Extreme weather events pose major risks to human health and have a greater psychological impact on women and parents, but little is known about how they affect health risk behaviors. This study evaluated how disaster-related experiences before, during, and after Hurricane Irma were associated with mothers' health-risk behaviors, and the extent to which posttraumatic stress symptoms (PTSS) and depressive symptoms potentially mediated these relationships. METHOD: Mothers (N = 534; 33% underrepresented minorities) residing in Southern Florida completed an online survey about their evacuation experiences before and hurricane experiences during and after Irma. Mothers also completed measures of PTSS, depressive symptoms, and health risk behaviors (i.e., substance use, sedentary behaviors, and difficulty falling or staying asleep). Confirmatory factor analysis assessed the fit of the health-risk behavior indicators on a latent factor. Structural equation modeling evaluated relationships between variables. RESULTS: A one-factor model for health risk behaviors fit the data well. After controlling for income, loss and disruption after the storm and depressive symptoms were directly associated with mothers' health risk behaviors. Before-the-storm evacuation stressors, actual life-threatening events during the storm, and loss and disruption after the storm were related to mothers' PTSS and depressive symptoms and also associated with health risk behaviors indirectly via depressive symptoms. CONCLUSIONS: Stressful experiences before, during, and after hurricanes are associated with mothers' health-risk behaviors via postevent emotional distress. Health interventions should include strategies that help parents cope with the impact of extreme weather events, both before and after such events occur. Mothers' distress potentially could affect child health. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Measurement Invariance and Latent Mean Differences Between American, Spanish and Chinese Adolescents Using the Social Anxiety Scale for Adolescents (SAS-A).

BACKGROUND: Social anxiety is one of the most prevalent disorders among adolescents (Stein et al., 2017). The main aim of this study was to analyze the equivalence of scores on the Social Anxiety Scale for Adolescents (SAS-A) using structural equation modeling and identify differences in latent means of social anxiety in China, Spain, and the USA. METHOD: Random sampling was used to recruit participants, which included 536 Chinese (46% girls), 1,178 Spanish (55.3% girls) and 866 North American (55.1% girls) adolescents. The participants' ages ranged between 14 and 17 years old. RESULTS: The SAS-A three-factor correlated model of social anxiety remained invariant between the Spanish and North American adolescents, but results could not be replicated in the Chinese adolescents [M2 = ΔS-Bχ² (Δdf, p) = 4732.56 (36, < .01)]. Analyses of latent differences between Spain and the USA showed that Spanish adolescents had higher scores than North Americans for Fear of Negative Evaluation (TS = -9.630; d = .44) and for Social Avoidance and General Anxiety towards people (TS = -2.717; d = .12). CONCLUSIONS: The results are interpreted according to the cultural traits of individualism-collectivism and self-construal, and practical implications are discussed.

Measurement Invariance and Latent Mean Differences Between American, Spanish and Chinese Adolescents Using the Social AnxietyScale for Adolescents (SAS-A) / Análisis de Invarianza y Diferencias de Medias Latentes Entre Adolescentes Americanos, Españoles y Chinos Usando la Escala deAnsiedad Social para Adolescentes (SAS-A)

Background: Social anxiety is one of the most prevalent disorders amongadolescents (Stein et al., 2017). The main aim of this study was to analyzethe equivalence of scores on the Social Anxiety Scale for Adolescents(SAS-A) using structural equation modeling and identify differences inlatent means of social anxiety in China, Spain, and the USA. Method:Random sampling was used to recruit participants, which included 536Chinese (46% girls), 1,178 Spanish (55.3% girls) and 866 North American(55.1% girls) adolescents. The participants’ ages ranged between 14 and17 years old. Results: The SAS-A three-factor correlated model of socialanxiety remained invariant between the Spanish and North Americanadolescents, but results could not be replicated in the Chinese adolescents[M2 = ΔS-Bχ2 (Δdf, p) = 4732.56 (36, < .01)]. Analyses of latent differencesbetween Spain and the USA showed that Spanish adolescents had higherscores than North Americans for Fear of Negative Evaluation (TS = -9.630;d = .44) and for Social Avoidance and General Anxiety towards people(TS = -2.717; d = .12). Conclusions: The results are interpreted accordingto the cultural traits of individualism-collectivism and self-construal, andpractical implications are discussed.

Antecedentes: la ansiedadsocial es uno de los trastornos con mayor prevalencia en adolescentes(Stein et al., 2017). Así, el propósito principal de este estudio fue analizarla invarianza de la Escala de Ansiedad Social para Adolescentes (SAS-A) mediante un modelo de ecuaciones estructurales y examinar las diferenciasde medias latentes en ansiedad social en adolescentes de China, España y EE.UU. Método: los participantes se seleccionaron a través de muestreoaleatorio: 534 chinos (46% chicas), 1.178 españoles (55,3% chicas) y866 norteamericanos (55,1% chicas), con edades comprendidas entre los14 y 17 años. Resultados: las puntuaciones del modelo de tres factorescorrelacionados de ansiedad social de la SAS-A resultaron invariantesentre adolescentes españoles y norteamericanos, pero estos resultados nofueron replicados en adolescentes chinos [M2 = ΔS-Bχ2 (Δdf, p) = 4732.56(36, < .01)]. El análisis de medias latentes entre España y EE.UU. mostróque los adolescentes españoles manifestaban niveles más altos de Miedoante las evaluaciones negativas (TS = -9.630; d = .44) y Evitación social yansiedad general hacia las personas (TS = -2.717; d = .12).Conclusiones: estos hallazgos fueron interpretados atendiendo al de individualismo-colectivismo y las concepciones culturales de la propia persona, analizandosus implicaciones prácticas.

The stress before the storm: Psychological correlates of hurricane-related evacuation stressors on mothers and children.

OBJECTIVE: Natural disasters, such as hurricanes, can contribute to the development of posttraumatic stress symptoms (PTSS), anxiety, and depression. Furthermore, mothers and children are especially vulnerable postdisasters. Despite the rise in the frequency of climate-related disasters and also the threat of disasters (e.g., storms that threaten but do not make landfall), little is known about how predisaster experiences are associated with mothers' and children's postdisaster psychological functioning. This study examined evacuation-related stressors as predictors of mothers' and youths' psychological functioning 3 months after Hurricane Irma. METHOD: Mothers (N = 535; 33% ethnic/racial minorities) from South Florida counties most affected by Hurricane Irma completed an online survey that assessed evacuation-related stressors (both pre- and posthurricane), hurricane exposure (i.e., life threat, loss/disruption), and posthurricane social support and mental health symptomatology (i.e., PTSS, anxiety, depression). Mothers of children aged 7-17 years (n = 226) also reported on their child's psychological functioning. RESULTS: Using a risk and resilience model, evacuation stressors significantly predicted mothers' and youths' PTSS and symptoms of anxiety and depression, even after accounting for demographic factors, hurricane exposure, and availability of social support. Mothers of older children also reported significantly higher levels of PTSS, anxiety, and depression than mothers who only had young children (aged 6 or younger) at home. CONCLUSIONS: Evacuation experiences represent significant stressors that may put mothers and children at risk for PTSS and psychological distress. Resilience-building efforts should include efforts to better prepare families for prestorm evacuations, thereby reducing risk in mothers and youth and ultimately contributing to better psychosocial functioning. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Neural vulnerability and hurricane-related media are associated with post-traumatic stress in youth.

The human toll of disasters extends beyond death, injury and loss. Post-traumatic stress (PTS) can be common among directly exposed individuals, and children are particularly vulnerable. Even children far removed from harm's way report PTS, and media-based exposure may partially account for this phenomenon. In this study, we examine this issue using data from nearly 400 9- to 11-year-old children collected before and after Hurricane Irma, evaluating whether pre-existing neural patterns moderate associations between hurricane experiences and later PTS. The 'dose' of both self-reported objective exposure and media exposure predicted PTS, the latter even among children far from the hurricane. Furthermore, neural responses in brain regions associated with anxiety and stress conferred particular vulnerability. For example, heightened amygdala reactivity to fearful stimuli moderated the association between self-reported media exposure and PTS. Collectively, these findings show that for some youth with measurable vulnerability, consuming extensive disaster-related media may offer an alternative pathway to disaster exposure that transcends geography and objective risk.

What's in a name? Comparing alternative conceptualizations of posttraumatic stress disorder among preadolescent children following the Boston Marathon bombing and manhunt.

BACKGROUND AND OBJECTIVES: New diagnostic criteria for posttraumatic stress disorder (PTSD) were introduced by DSM-5 and ICD-11. It remains unclear how well these new definitions of PTSD capture the posttrauma responses of children, particularly when using parent report. This study compared different conceptual models of PTSD in children following the Boston Marathon bombing and manhunt. DESIGN AND METHODS: Parents/caretakers (N = 254) reported on PTSD symptoms of their children (ages 4-11) following the Boston Marathon bombing and manhunt. Algorithms compared criteria from ICD-11, DSM-IV, and DSM-5 (specifically the "Preschool" criteria). RESULTS: DSM-5 Preschool criteria identified twice as many children as ICD-11, and over four times as many as DSM-IV. DSM-5 Preschool criteria identified all cases detected by ICD-11 and DSM-IV. Across models, all identified cases had greater trauma exposure than non-identified children. DSM-5 Preschool and ICD-11 (but not DSM-IV) cases had greater clinical decline than non-identified children. The Avoidance cluster showed the most variability in identifying cases. CONCLUSIONS: Newer models of PTSD are likely to identify more children than DSM-IV, mostly related to changes in the Avoidance criteria. The DSM-5 Preschool definition is the most inclusive model. ICD-11 may provide a balance between inclusivity and stringency in detecting childhood PTSD.

Trajectories of Posttraumatic Stress in Youths After Natural Disasters.

Importance: Disaster exposure is associated with the development of posttraumatic stress (PTS) symptoms in youths. However, little is known about how to predict which youths will develop chronic PTS symptoms after disaster exposure. Objective: To evaluate PTS symptom trajectories among youths after 4 major US hurricanes and assess factors associated with those trajectories. Design, Setting, and Participants: This cohort study used integrative data analysis to combine data from 4 studies of youths' responses to natural disasters (hurricanes Andrew [1992], Charley [2004], Ike [2005], and Katrina [2008]) at time points ranging from 3 to 26 months after the disasters. Those studies recruited and surveyed youths aged 6 to 16 years at schools via convenience sampling of schools near the path of destruction for each hurricane. This study was conducted from August 2017 to August 2020, and pooled data were analyzed from February 2019 to October 2020. Exposure: Experience of a natural disaster during the ages of 6 to 16 years. Main Outcomes and Measures: Posttraumatic stress symptoms were assessed using the University of California, Los Angeles, Posttraumatic Stress Disorder Reaction Index (UCLA PTSD-RI) and the UCLA PTSD-RI-Revised. Latent class growth analyses were used to evaluate the youths' PTS symptom trajectories and associated factors. Results: Among 1707 youths included in the study, the mean (SD) age was 9.61 (1.60) years, 922 (54%) were female, and 785 (46%) self-identified as White non-Hispanic. Four PTS symptom trajectories were identified: chronic (171 participants [10%]), recovery (393 [23%]), moderate-stable (563 [33%]), and low-decreasing (580 [34%]). Older youths were less likely to be in the chronic group; compared with the chronic group, each 1-year increase in age was associated with increased odds of being in the other groups (recovery: odds ratio [OR], 1.78 [95% CI, 1.29-2.48]; moderate-stable: OR, 1.94 [95% CI, 1.43-2.62]; and low-decreasing: OR, 2.71 [95% CI, 1.99-3.71]). Compared with males, females had higher odds of being in the chronic group than in any other group (recovery group: OR, 0.48 [95% CI, 0.26-0.91]; moderate-stable group: OR, 0.37 [95% CI, 0.21-0.64]; and low-decreasing group: OR, 0.25 [95% CI, 0.14-0.44]). Conclusions and Relevance: In this cohort study, few youths reported chronic distress, and trajectories among most youths reflected recovery or low-decreasing PTS symptoms. Older age and identification as male were factors associated with decreased odds of a chronic trajectory. Youths with chronic or moderate-stable trajectories may benefit from intervention.

Bullying Involvement in Adolescence: Implications for Sleep, Mental Health, and Academic Outcomes.

Adolescents' involvement in bullying is associated with both sleep and mental health problems, but the nature of this association remains unclear; further, its association with academic outcomes has received little attention. Thus, the aims of the current study were to (a) determine whether involvement in bullying as a victim, bully, or bully-victim was associated with greater sleep and mental health problems and (b) explore the potential mediating effect of sleep and mental health problems on the association between bullying and academic outcomes. A large 2012 population-based study in Hordaland County, Norway, surveyed 10,220 adolescents (16-19 years; 54% girls) about bullying involvement using the revised version of the Olweus Bully/Victim Questionnaire, detailed sleep assessment, and mental health questionnaires. Academic outcomes were obtained from official administrative registries. 1.7% of the adolescents (n = 156) reported being victims of bullying, 1.0% (n = 92) reported being a bully, and 0.5% (n = 50) reported being a bully-victim. All categories of bullying involvement had higher rates of mental health problems compared with adolescents not involved in bullying. Victims reported more symptoms of anxiety and depression, whereas bullies reported higher rates of conduct problems. Adolescents in all bullying categories also reported significantly shorter sleep duration and higher prevalence of insomnia as well as lower grade point average (GPA) compared with adolescents not involved; however, school absence was not associated with bullying involvement. Bullying involvement and GPA showed complete mediation for bullies and bully-victims and partial mediation for victims through sleep duration, conduct problems, and symptoms of depression and attention deficit hyperactivity disorder (ADHD). Bullying is strongly associated with mental health and sleep problems, in addition to lower academic performance. Findings support the importance of addressing bullying involvement during this important developmental period.

The role of empathy and social anxiety in Latinx adolescents' indirect peer aggression during the transition to high school.

The primary purpose of this study was to evaluate the relationship between decreased empathy (i.e., cognitive and affective) and indirect and cyber peer aggression among Latinx adolescents during their transition to high school. Further, we examined the degree to which social anxiety moderated this relationship. Participants were 469 Latinx ninth graders, ages 13-17 years (M = 14.52, SD = 0.58; 58% girls). Adolescents completed the Revised Peer Experiences Questionnaire, Cyber Peer Experiences Questionnaire, Basic Empathy Scale, and Social Anxiety Scale for Adolescents at two different time points, 3 months apart. Hierarchical linear regression analyses revealed concurrent and prospective relationships between lower cognitive empathy and the perpetration of both indirect and cyber aggression. In addition, social anxiety moderated the concurrent associations between both types of empathy and both types of aggression perpetration. Results suggest that interventions that facilitate cognitive empathy and decrease social anxiety may help to reduce adolescents' indirect and cyber aggression toward peers throughout the high school transition.

Treating Children and Adolescents with Posttraumatic Stress Disorder: Moderators of Treatment Response.

Youth exposed to a wide range of potentially traumatic events, such as natural disasters, acts of violence, terrorism, motor vehicle accidents, and life-threatening illnesses, are at risk for developing posttraumatic stress disorder (PTSD) or significant posttraumatic stress symptoms (PTSS). Recent reviews of the existing evidence-base for the treatment of PTSD in children and adolescents identified trauma-focused cognitive behavioral therapy (TF-CBT) and cognitive behavioral therapy (CBT) as well-established treatments. However, studies that evaluated treatment moderators have been scant. Research on treatment moderators is important for guiding clinical decision-making around selecting treatments that might be most effective given the characteristics and circumstances of a particular child or adolescent. Thus, this article provides an updated review of potential moderators evaluated in recent (i.e., past 5 years) meta-analyses and systematic reviews of psychological treatments for PTSD in youth. The moderators examined were in the areas of youth characteristics (age, gender, ethnicity, domicile), parent/caregiver factors (involvement, functioning), trauma type, and treatment factors (dose, individual/group, provider, exposure elements, sudden gains). Some support was identified for age, gender, domicile, parent/caregiver involvement, maternal depressive symptoms, treatment dose, individual/group, and sudden gains as possible treatment moderators, although the strength of the evidence varied and more research is needed to clarify findings. Further study of moderators will be essential to advance the knowledge base in the treatment of PTSD in youth.

Mental health and clinical psychological science in the time of COVID-19: Challenges, opportunities, and a call to action.

COVID-19 presents significant social, economic, and medical challenges. Because COVID-19 has already begun to precipitate huge increases in mental health problems, clinical psychological science must assert a leadership role in guiding a national response to this secondary crisis. In this article, COVID-19 is conceptualized as a unique, compounding, multidimensional stressor that will create a vast need for intervention and necessitate new paradigms for mental health service delivery and training. Urgent challenge areas across developmental periods are discussed, followed by a review of psychological symptoms that likely will increase in prevalence and require innovative solutions in both science and practice. Implications for new research directions, clinical approaches, and policy issues are discussed to highlight the opportunities for clinical psychological science to emerge as an updated, contemporary field capable of addressing the burden of mental illness and distress in the wake of COVID-19 and beyond. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Stressors, Repetitive Negative Thinking, and Insomnia Symptoms in Adolescents Beginning High School.

OBJECTIVE: Although the first year of high school may represent a particularly stressful time for adolescents, no research addresses how stressors are related to insomnia symptoms during this time. Thus, we examined how stress relates to concurrent and prospective insomnia symptoms in adolescents beginning high school (Aim 1). Additionally, we assessed repetitive negative thinking (RNT) as a mediator (Aim 2). We also evaluated whether the pattern of associations differed for boys and girls (Aim 3). METHODS: Adolescents (N = 502; M age = 14.22 years; 58.2% girls; 91.2% Hispanic/Latinx) completed questionnaires about stressors related to beginning high school (e.g., school performance, peer pressure), family support, RNT, and insomnia symptoms at the beginning and end of their first year of high school. Multiple group structural equation models assessed relationships between these variables and evaluated differences between boys and girls. RESULTS: School/leisure conflict and low family support were directly associated with insomnia symptoms at both times, and RNT mediated these relationships in both boys and girls. In girls, peer pressure and low family support were indirectly associated with Time 1 and Time 2 insomnia symptoms via RNT. In boys, school performance was indirectly associated with Time 1 and Time 2 insomnia symptoms via RNT. CONCLUSIONS: Stressful experiences at the beginning of high school negatively affect sleep in adolescents both in the short and long term. Pediatric psychologists should educate adolescents and their parents about the risk of sleep problems during this time period and provide strategies for stress management and for proper sleep hygiene.