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.

From greenwashing to screenwashing?

In this viewpoint, we introduce the term 'screenwashing', which describes the phenomenon whereby social media platforms, such as TikTok and Instagram, pretend to be more socially responsible than they actually are. That is, social media platforms pretend to be thoughtful about children's health and the prevention of problematic social media use, but this often turns out to be nothing more than "a lick of paint". We describe how features like the one-hour notification on TikTok and Instagram are considered screenwashing and why we believe so. Screenwashing, an unethical practice, has the potential to mislead parents and young users. Consequently, we advocate for increased government intervention to protect our youth from the potential hazards associated with problematic social media use.

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.

Associations Between Borderline Personality Disorder Symptoms and Online Self-Disclosure in Clinically Referred Youth.

Communicating online via social media has proven to facilitate disclosure of intimate topics and can therefore be helpful in the development of intimate relationships. However, for youth with borderline personality disorder (BPD) symptoms, it may be more difficult to know when, what, and to whom to disclose (i.e., effective disclosure) in online contacts. The authors examine associations between BPD symptoms, online self-disclosure, and ineffective online self-disclosure (e.g., regretting sharing something online). The sample consisted of 235 clinically referred youth (66.4% female), aged 12-25 years (M = 17.82, SD = 2.96). Structural equation modeling revealed that BPD symptoms were related to higher levels of same- and cross-sex online self-disclosure as well as to more ineffective online self-disclosure. There was no moderation by sex or age. This study suggests that youth with BPD symptoms are at risk for oversharing personal information, which could affect forming and maintaining intimate relationships and increases online risks.

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.

Problematic Internet Use in Adolescents from Divorced Families: The Role of Family Factors and Adolescents' Self-Esteem.

Family functioning is salient in explaining adolescents' problematic internet use (PIU), and precisely this family functioning is under pressure after parental divorce. Moreover, growing up with divorced parents is identified as a risk factor for PIU. Therefore, examining which factors are associated with adolescents' PIU after divorce is particularly important. Based on self-report data from N = 244 adolescents of divorced families (49.6% boys, M = 13.42), structural equation modeling (SEM) was used to examine the associations of PIU with interparental conflict, triangulation, maternal and paternal warmth, and adolescents' self-esteem. Potential buffering effects of self-esteem were tested, as well as gender differences in associations. The results showed that more triangulation and less maternal warmth were related to higher levels of PIU, but these effects disappeared after adding self-esteem to the models. Adolescent self-esteem did not significantly buffer the effects of the different family factors on PIU, nor were there any significant gender differences in association. Hence, especially adolescents' self-esteem seems to be a key aspect for PIU in adolescents from divorced families.

Social Media and Mental Health Among Early Adolescents in Sweden: A Longitudinal Study With 2-Year Follow-Up (KUPOL Study).

PURPOSE: The aim of this study is to assess the longitudinal associations between the frequency of social media use and symptoms of mental ill-health among Swedish adolescents. METHODS: Data came from KUPOL, a Swedish school-based longitudinal cohort accrued in 101 participating schools in 8 regions of Sweden. The study sample consisted of 3,501 adolescents in grade 8 (14-15 years, 51.5%, n = 1,765 girls) followed for 2 consecutive years. Daily social media use was measured as weighted average of self-reported use in weekdays and weekend days. Mental health was measured with the Strength and Difficulties Questionnaire (SDQ). A Random-Intercept Cross-Lagged Panel Model was applied to distinguish between-person from within-person associations between social media use and symptoms of mental ill-health. RESULTS: Median SDQ score at baseline was 9 (interquartile range [IQR] 6-14). Median social media use was 1.7 hours at baseline (interquartile range .6-3.0) and increased over the 3-year period. Adolescents with more social media use also reported higher SDQ scores, B (95% confidence interval [CI]) = 2.40 (2.03-2.77). On a within-person level, no cross-lagged associations were found between changes in social media use and subsequent changes in symptoms of mental ill-health after 1 year, B (95% CI) = .02 (-.12 to .16) or vice versa B (95% CI) = .00 (-.02 to .02). Weak cross-sectional associations were found between changes in social media use and concurrent changes in symptoms of mental ill-health, B (95% CI) = .24 (.00-.48). CONCLUSIONS: Adolescents with higher use of social media report more symptoms of mental health problems, but there is no evidence for a longitudinal association between increased use and mental health problems. This suggests that social media may be rather an indicator than a risk factor for symptoms of mental ill-health.

Underlying Psychophysiology of Dysregulation: Resting Heart Rate and Heart Rate Reactivity in Relation to Childhood Dysregulation.

OBJECTIVE: High co-occurrence of externalizing and internalizing problems could underlie inconsistent findings regarding the relation between heart rate (HR) and psychopathology. In this study, HR measures were examined in relation to a general dysregulation profile studied from variable- and person-centered approaches. METHOD: The sample (N = 182) consisted of 8- to 12-year-old children referred for externalizing behaviors and typically developing children (mean age 9.70, SD 1.26; 75.8% boys). Resting HR (HRrest) was assessed during a 3-minute resting period. HR reactivity (HRreactivity) was assessed during an emotionally evoking go/no-go task. RESULTS: From a variable-centered approach, a bifactor model was fitted with a general factor of dysregulation underlying symptoms of anxiety/depression, aggression, and attention problems. HRrest was positively associated with dysregulation and specific aggression. From a person-centered approach, a latent profile analysis was used to identify different psychopathology classes: normative (n = 92), predominantly aggressive (n = 69), and dysregulated (n = 14). The latter was characterized by co-occurring increased levels of anxiety/depression, aggression, and attention problems. HRrest was increased in the predominantly aggressive class and HRreactivity was increased in the dysregulated class. CONCLUSION: High HRrest, or (trait-like) over-arousal, seems to be associated with dysregulation rather than uniquely associated with low externalizing or high internalizing symptomatology. In addition, HRrest predicted greater aggression and HRrest was increased in the predominantly aggressive class. High HRreactivity, or enhanced emotional reactivity, might be characteristic for a clinically relevant dysregulated subgroup. Assessment of HR could provide additional knowledge on individual differences that can help refine diagnostics and intervention efforts.

Social Media and Body Dissatisfaction: Investigating the Attenuating Role of Positive Parent-Adolescent Relationships.

Previous research has shown that adolescents´ social media use predicts increased body dissatisfaction. However, little is known about social environmental factors that may attenuate this relationship. This study examines one such potential moderating social environmental factor: positive parent-adolescent relationships. A school-based survey was conducted among 440 adolescents aged 12 to 19 (M= 14.9, SD= 1.8, 47% female). On average, social media use was positively associated with body dissatisfaction, but this relationship was weaker among adolescents who reported a more positive mother-adolescent relationship. Positive father-adolescent relationship did not moderate the association between social media use and body dissatisfaction. These findings may indicate that adolescents' social environment, notably the relationship they have with their mothers, can protect them against the detrimental effects of social media use on body dissatisfaction. However, longitudinal and experimental studies are needed to examine the direction of effects and test the validity of this interpretation.

Evaluation of the Strengths and Difficulties Questionnaire-Dysregulation Profile (SDQ-DP).

The Dysregulation Profile (DP) has emerged as a measure of concurrent affective, behavioral and cognitive dysregulation, associated with severe psychopathology, and poor adjustment. While originally developed with the Child Behavior Checklist, more recently the DP has also been defined on the Strengths and Difficulties Questionnaire (SDQ), mostly with a 5-item, but also a 15-item, SDQ-DP measure. This study evaluated the SDQ-DP by examining its factor structure, measurement invariance, and construct validity. Different SDQ-DP operationalizations were compared. In a United States longitudinal community sample (N = 768), a bifactor model consisting of a general Dysregulation factor and three specific factors of Emotional Symptoms, Conduct Problems, and Hyperactivity-Inattention fitted best, across three different developmental periods (early childhood, middle childhood, and adolescence) and across three different reporters (parents, teachers, and youth). Measurement invariance across reporter, gender, and developmental period was demonstrated. These findings indicate that the SDQ-DP, like the CBCL-DP, reflects a broad syndrome of dysregulation that exists in addition to specific syndromes of emotional symptoms, conduct problems, and hyperactivity-inattention. SDQ-DP bifactor scores were strongly related with scores on the 5- and 15-item SDQ-DP measures and similarly concurrently associated with two markers of self-regulation, ego-resiliency and effortful control, and longitudinally with antisocial behavior and disciplinary measures. As reliability, validity, and stability was weaker for the SDQ-DP 5-item measure, use of all 15 items is recommended. Advantages of using a bifactor approach are discussed as well as the potential of the SDQ-DP as an easy screening measure of children at risk for developing serious psychopathology. (PsycINFO Database Record

Normative development of the Child Behavior Checklist Dysregulation Profile from early childhood to adolescence: Associations with personality pathology.

The Dysregulation Profile (DP) is a broad indicator of concurrent affective, behavioral, and cognitive dysregulation, often measured with the anxious/depressed, aggressive behavior, and attention problems syndrome scales of the Child Behavior Checklist. Despite an expanding body of research on the DP, knowledge of the normative developmental course of the DP from early childhood to adolescence is lacking. Furthermore, although we know that the DP longitudinally predicts personality pathology, no research yet has examined whether next to the DP in early childhood, the rate of change of the DP across development predicts personality pathology. Therefore, using cohort-sequential latent growth modeling in a population-based sample (N = 668), we examined the normative developmental course of mother-reported DP from ages 4 to 17 years and its associations with a wide range of adolescent-reported personality pathology dimensions 3 years later. The results showed that the DP follows a nonlinear developmental course with a peak in early adolescence. The initial level of the DP at age 4 and, to a lesser extent, the rate of change in the DP predicted a range of personality pathology dimensions in late adolescence. The findings suggest that the DP is a broad developmental precursor of personality pathology in late adolescence.

The concurrent and longitudinal relationships between adolescents' use of social network sites and their social self-esteem.

The first aim of this study was to investigate the concurrent and longitudinal relationships between adolescents' use of social network sites (SNSs) and their social self-esteem. The second aim was to investigate whether the valence of the feedback that adolescents receive on SNSs can explain these relationships. We conducted a three-wave panel study among 852 pre- and early adolescents (10-15 years old). In line with earlier research, we found significant concurrent correlations between adolescents' SNS use and their social self-esteem in all three data waves. The longitudinal results only partly confirmed these concurrent findings: Adolescents' initial SNS use did not significantly influence their social self-esteem in subsequent years. In contrast, their initial social self-esteem consistently influenced their SNS use in subsequent years. The valence of online feedback from close friends and acquaintances explained the concurrent relationship between SNS use and social self-esteem, but not the longitudinal relationship. Results are discussed in terms of their methodological and theoretical implications.

Does habituation differ in chronic low back pain subjects compared to pain-free controls? A cross-sectional pain rating ERP study reanalyzed with the ERFIA multilevel method.

The objective of the present study was to investigate cortical differences between chronic low back pain (CLBP) subjects and pain-free controls with respect to habituation and processing of stimulus intensity. The use of a novel event-related fixed-interval areas (ERFIA) multilevel technique enables the analysis of event-related electroencephalogram (EEG) of the whole post stimulus range at a single trial level. This technique makes it possible to disentangle the cortical processes of habituation and stimulus intensity.In a cross-sectional study, 78 individuals with CLBP and 85 pain-free controls underwent a rating paradigm of 150 nonpainful and painful somatosensory electrical stimuli. For each trial, the entire epoch was partitioned into 20-ms ERFIAs, which acted as dependent variables in a multilevel analysis. The variability of each consecutive ERFIA period was modeled with a set of predictor variables, including 3 forms of habituation and stimulus intensity.Seventy-six pain-free controls and 65 CLBP subjects were eligible for analysis. CLBP subjects showed a significantly decreased linear habituation at 340 to 460 ms in the midline electrodes and C3 (Ps < .05) and had a significantly more pronounced dishabituation for the regions of 400 to 460 ms and 800 to 820 ms for all electrodes, except for T3 and T4 (Ps < .05). No significant group differences for stimulus intensity processing were observed.In this study, group differences with respect to linear habituation and dishabituation were demonstrated. By means of the ERFIA multilevel technique, habituation effects were found in a broad post stimulus range and were not solely limited to peaks. This study suggests that habituation may be a key mechanism involved in the transition process to chronic pain. Future studies with a longitudinal design are required to solve this issue.

Introducing the event related fixed interval area (ERFIA) multilevel technique: a method to analyze the complete epoch of event-related potentials at single trial level.

In analyzing time-locked event-related potentials (ERPs), many studies have focused on specific peaks and their differences between experimental conditions. In theory, each latency point after a stimulus contains potentially meaningful information, regardless of whether it is peak-related. Based on this assumption, we introduce a new concept which allows for flexible investigation of the whole epoch and does not primarily focus on peaks and their corresponding latencies. For each trial, the entire epoch is partitioned into event-related fixed-interval areas under the curve (ERFIAs). These ERFIAs, obtained at single trial level, act as dependent variables in a multilevel random regression analysis. The ERFIA multilevel method was tested in an existing ERP dataset of 85 healthy subjects, who underwent a rating paradigm of 150 painful and non-painful somatosensory electrical stimuli. We modeled the variability of each consecutive ERFIA with a set of predictor variables among which were stimulus intensity and stimulus number. Furthermore, we corrected for latency variations of the P2 (260 ms). With respect to known relationships between stimulus intensity, habituation, and pain-related somatosensory ERP, the ERFIA method generated highly comparable results to those of commonly used methods. Notably, effects on stimulus intensity and habituation were also observed in non-peak-related latency ranges. Further, cortical processing of actual stimulus intensity depended on the intensity of the previous stimulus, which may reflect pain-memory processing. In conclusion, the ERFIA multilevel method is a promising tool that can be used to study event-related cortical processing.

Prolonged stay at the paediatric intensive care unit associated with paediatric delirium.

The objective of this study was to investigate, under circumstances of routine care, the impact of paediatric delirium (PD) on length of stay in the paediatric intensive care unit (PICU) as well as on direct financial costs. A five-year prospective observational study (2002-2007) was carried out in a tertiary eight-bed PICU in the Netherlands. Critically ill children aged 1 to 18 years who were acutely, non-electively and consecutively admitted to the PICU and detected as having PD in routine care were compared to critically ill children aged 1 to 18 years without signs of PD. PD, population characteristics and severity of illness at admission were used as predictors for length of PICU stay. Differences in length of stay yielded short-term, direct medical costs associated with PD. Forty-nine children with and 98 children without PD were included. PD prolonged length of PICU stay with 2.39 days, independent of severity of illness, age, gender, mechanical ventilation and medical indication for admission (B = 0.38, P < 0.001). PD increased direct medical costs with 1.5%. The results suggest a negative prognostic influence of PD on duration of PICU stay in routine care, resulting in an increase of direct medical costs.

Evidence that trait-anxiety and trait-depression differentially moderate cortical processing of pain.

OBJECTIVES: The purpose of this study was to examine the influence of neuroticism (N) and its different subfacets anxiety (N-anx) and depression (N-dep) on cortical pain processing expressed as event-related potentials (ERPs). METHODS: Seventy-five healthy participants received electrical pain stimuli under condition of simultaneous electroencephalogram registration. Multiple regression analyses were conducted to study the amount of pain-ERP variance. ERP variance was explained by N and its subfacets. RESULTS: N moderated the way pain was processed cortically. Higher levels of N were associated with higher pain-ERP amplitudes. Within this association, differential subfacet effects were observed: N-anx reduced, whereas N-dep augmented pain-ERP amplitudes. DISCUSSION: A personality trait reflecting bias toward negative emotions may moderate the way pain is processed cortically, with directionally different effects depending on whether the trait is expressed predominantly in the realm of anxiety or depression.