Asthma and Adolescence: Unique Opportunities for Fostering Asthma Self-Management and Asthma Control.

Asthma is a significant worldwide concern among adolescents. Adolescents experience key cognitive and psychosocial developmental changes that they must negotiate as they transition from children to adults. Several of these changes have implications for their ability to effectively manage their asthma. When health care professionals (HCPs) understand these pivotal changes and their role in asthma management, they are better able to work with adolescents and help them become effective asthma self-managers. Therefore, this article reviews the cognitive changes that render adolescents ready to care for their asthma, as well as the following psychosocial changes that may hinder or facilitate self-management: independence from caregivers, reliance on peers, identity development, the role of social media in adolescents' lives, and risk-taking behaviors. Each developmental task is discussed in terms of asthma self-management and offers suggestions for HCPs that may help them work more effectively with adolescents with asthma.

Altered learning from positive feedback in adolescents with anorexia nervosa.

OBJECTIVE: Anorexia nervosa (AN) is characterized by severe restriction of calorie intake, which persists despite serious medical and psychological sequelae of starvation. Several prior studies have identified impaired feedback learning among individuals with AN, but whether it reflects a disturbance in learning from positive feedback (i.e., reward), negative feedback (i.e., punishment), or both, and the extent to which this impairment is related to severity and duration of illness, has not been clarified. METHOD: Participants were female adolescents with AN (n = 76) and healthy teen volunteers (HC; n = 38) between the ages of 12-18 years who completed a probabilistic reinforcement learning task. A Bayesian reinforcement learning model was used to calculate separate learning rates for positive and negative feedback. Exploratory analyses examined associations between feedback learning and duration of illness, eating disorder severity, and self/parent reports of reward and punishment sensitivity. RESULTS: Adolescents with AN had a significantly lower rate of learning from positive feedback relative to HC. Patients and HC did not differ in learning from negative feedback or on overall task performance measures. Feedback learning parameters were not significantly associated with duration of illness, eating disorder severity, or questionnaire-based reports of reward and punishment sensitivity. CONCLUSION: Adolescents with AN showed a circumscribed deficit in learning from reward that was not associated with duration of illness or reported sensitivity to reward or punishment. Subsequent longitudinal research should explore whether differences in learning from positive feedback relate to course of illness in youth with AN.

COVID-19, school closures and the retreat from educational aspirations.

INTRODUCTION: As a shared external shock, the coronavirus pandemic (COVID-19) impacted health and well-being around the world. Mitigation strategies employed in many locations included school closures and travel restrictions. These strategies directly impacted educational access and opportunities and created economic stressors for families. This study examines how these direct impacts also altered educational aspirations for children and adolescents, an important predictor of educational attainment. METHOD: We estimate multilevel regression models using two waves of data, collected in 2017-18 and 2020-21, from 1294 children and adolescents (Mean age = 13.1, SD = 2.8; 50.3% female) in Jalisco, Mexico, and 2201 children and adolescents (Mean age = 14.7, SD = 2.6; 49.1% female) in Chitwan Nepal. We examine changes in educational aspirations between the two waves (pre- and post-COVID-19 onset). RESULTS: Initial aspirations are positively associated with household wealth, caregiver education, and prior commitment to education. Multilevel regression models predicting changes in educational aspirations demonstrate these resources are important for maintaining high educational aspirations. But children and adolescents in households that experienced more economic loss following the external shock of the pandemic had lowered aspirations over time. CONCLUSIONS: Disruptions to schooling and economic shocks to households curtailed educational aspirations among children and adolescents in a similar way in two disparate settings. These results raise concerns about the educational attainment of children in the face of external shocks and the possibility that educational progress will stall in low resourced environments among the most vulnerable youth.

Prefrontal Excitation/ Inhibition Balance Supports Adolescent Enhancements in Circuit Signal to Noise Ratio.

The development and refinement of neuronal circuitry allow for stabilized and efficient neural recruitment, supporting adult-like behavioral performance. During adolescence, the maturation of PFC is proposed to be a critical period (CP) for executive function, driven by a break in balance between glutamatergic excitation and GABAergic inhibition (E/I) neurotransmission. During CPs, cortical circuitry fine-tunes to improve information processing and reliable responses to stimuli, shifting from spontaneous to evoked activity, enhancing the SNR, and promoting neural synchronization. Harnessing 7T MR spectroscopy and EEG in a longitudinal cohort (N = 164, ages 10-32 years, 283 neuroimaging sessions), we outline associations between age-related changes in glutamate and GABA neurotransmitters and EEG measures of cortical SNR. We find developmental decreases in spontaneous activity and increases in cortical SNR during our auditory steady state task using 40 Hz stimuli. Decreases in spontaneous activity were associated with glutamate levels in DLPFC, while increases in cortical SNR were associated with more balanced Glu and GABA levels. These changes were associated with improvements in working memory performance. This study provides evidence of CP plasticity in the human PFC during adolescence, leading to stabilized circuitry that allows for the optimal recruitment and integration of multisensory input, resulting in improved executive function.

Wanting to matter and learning to care: A neurodevelopmental window of opportunity for (Pro) social learning?

Wanting to matter-to feel socially recognized, appreciated, and capable of actions that benefit others-represents a fundamental motivation in human development. The motivational salience of mattering appears to increase in adolescence. Evidence suggests this is related to pubertal increases in the incentive salience for gaining social value and personal agency. This can provide a useful heuristic for understanding motivational proclivities (i.e. wanting to matter) that influence action-outcome learning as young adolescents are exploring and learning how to navigate increasingly complex social and relational environments. Adolescence also brings new capacities, motives, and opportunities for learning to care about and contribute to the benefit of others. Together, these create a window of opportunity: a sensitive period for learning to gain salient feelings of mattering through caring prosocial actions and valued societal contributions. Successfully discovering ways of mattering by doing things that matter to others may contribute to formative socio-emotional learning about self/other. Advances in understanding these social and relational learning processes and their neurodevelopmental underpinnings can inform strategies to improve developmental trajectories of social competence and wellbeing among adolescents growing up in a rapidly changing and increasingly techno-centric world.

Pathways of Intergenerational Risk: Examining the Association Between Maternal Adverse Childhood Experiences and Child Socio-Emotional and Behavioral Concerns at 8 Years of Age.

Support has been found for the intergenerational transmission of risk from maternal adverse childhood experiences (ACEs) to child outcomes. Less research has focused on longitudinal psychosocial pathways that account for this transmission. In the current study, path analysis examined mediating pathways (i.e., maternal adult attachment insecurity, romantic relationship functioning, and maternal anxiety and depression symptoms) in the association between maternal ACEs and internalizing and externalizing concerns among their child at eight years of age. Participants included 1,994 mother-child dyads from a prospective longitudinal cohort sample. Maternal ACEs were significantly associated directly with child internalizing concerns (ß = .06, p = .025) and indirectly via both maternal attachment anxiety and avoidance, lower romantic relationship functioning, and depression, (ß = .002, p = .006; ß = .003, p = .005, respectively). Maternal ACEs were directly associated with child externalizing concerns (ß = .06, p = .018) and indirectly via both maternal attachment anxiety and avoidance, lower romantic relationship functioning, and depression, (ß = .001, p = .008; ß = .002, p = .010, respectively). This study identified several maternal risk factors that have implications for downstream internalizing and externalizing concerns among their children.

Does grit predict thriving or is it the other way around? A latent cross-lagged panel model on the triarchic model of grit and the 5Cs of positive youth development.

Grit, defined as passion and perseverance to achieve long-term goals, has been associated with adolescents' optimal academic and psychological functioning. However, the role of grit in adolescents' positive youth development (PYD)-characterized by the 5Cs known as competence, confidence, connection, character, and caring-remains unknown. Using latent cross-lagged panel modeling, this study examined the longitudinal relations between the triarchic model of grit (TMG) dimensions (i.e., perseverance of effort, consistency of interest, and adaptability to situations), and the 5Cs of PYD while controlling for specific socio-demographic covariates (gender, age, SES, and school type). Data were obtained from 1620 Filipino adolescents (Mage = 17.15; SDage = 1.00) in November 2021 and May 2022. Results show that grit dimensions predicted subsequent PYD dimensions, but not vice versa. Specifically, while perseverance and adaptability were linked to higher levels of competence, confidence, and character, consistency was associated with lower levels of competence and confidence six months later. Results highlight the importance of grit's dimensions in facilitating PYD characteristics among adolescents, especially efficacy-related Cs (competence and confidence). Theoretical and practical implications in promoting adolescent thriving and well-being are discussed.

Defining contribution: A scoping review.

INTRODUCTION: The term contribution is a key feature of approaches to positive youth development but has yet to be adequately defined. The purposes of this study were to identify properties that underlie contribution and to establish a theoretical definition of the construct. METHODS: A two-phase scoping review was conducted. The first phase involved the systematic search, selection, and analysis of studies from which six properties of contribution were identified and a preliminary theoretical definition was constructed. In the second phase expert judges rated the degree to that the proposed definition and the six properties of contribution fit with their conceptualization of the construct on a 6-point scale. RESULTS: Mean ratings for the definition and the six properties ranged from 5.05 to 5.70. Judges' ratings for the overall definition of contribution and the six properties were evaluated using Aiken's content validity coefficient (V). All V coefficients ranged in size from 0.81 to 0.94 and were statistically significant (p's < .01) indicating that the definition of contribution and the corresponding six properties fit well with experts' conceptualizations of the construct. CONCLUSION: This study provides a theoretical definition of contribution that will serve as a foundation upon which future research in the area of positive youth development can build.

Productive Messaging to Promote Youth Mental Well-Being and Positive Development in Clinical and Advocacy Settings.

In the adolescent mental health crisis, negative narrative communication has unitended consequences. Supportive communication involves reframing communications to find a new narrative that does not evoke biases. This narrative must emphasize agency and highlight the strengths, potential, and common experiences of young people. It is clear that supporting positive development and well-being is an "us" endeavor. There is a place in this communication strategy for pediatric professionals to address young people, caregivers, other health care professionals, and the community. The science of framing helps us shape a more supportive and productive discourse.

The role of nurses in implementation of public policy on adolescent health in Colombia, Ecuador, and Peru.

BACKGROUND: In Latin America, interventions aimed at adolescents' health suffer from a shortfall of investment and lack of sustainability. Nurses, as an integral part of health services and systems, can lead the implementation and development of public health policies to improve adolescent health. OBJECTIVE: To identify and analyze the role of nurses in the development and implementation of public policies and in the provision of health care to adolescents in Colombia, Ecuador, and Peru. METHODS: The research was carried out in three phases: a documentary analysis, an online survey, and semi-structured focus groups. A total of 48 documents were analyzed, 288 nurses participated in the survey, and 29 nurses participated in the focus groups. RESULTS: State policies aim to guarantee rights, with special protection for children and adolescents. It is an incremental process, with greater involvement of civil society and governments. Participants reported a lack of synergy between law and practice, as well as differences in regulatory compliance in rural areas and in populations of different ethnicities and cultures. Their perception was that the protection of adolescents is not specifically enshrined in the legal bases and regulatory structures of the countries, meaning that there are both protective factors and tensions in the regulatory framework. While nurses are highly committed to different actions aimed at adolescents, their participation in policy development and implementation is low, with barriers related to a lack of specialized training and working conditions. CONCLUSIONS: Given nurses' involvement in different actions aimed at adolescents, they could play a fundamental role in the development of policies for adolescents and ensure their effective implementation. Policymakers should consider revising the budget to make compliance viable, incorporating and using monitoring indicators, and increasing the involvement of educational institutions and the community.

Associations between parental civic engagement, negative beliefs toward civic engagement and youths' future civic attitudes and behaviors.

INTRODUCTION: Civic engagement (CE) in adolescence is associated with a higher level of engagement in adulthood and is reported to be beneficial to youth's development and societal well-being. Parents are among the most influential factors in adolescents' lives. This study examined the associations between parents' own civic participation, their negative beliefs toward youth CE and their child's future CE. While prior research documented positive associations between parental civic behaviors and youth CE, the role of parental negative beliefs has remained unexplored and could act as an additional barrier to adolescents' CE. METHODS: A total of 234 adolescents (65% girls; mean age = 13.77) and their parents (79% mothers; mean age = 44.20), residing in the Canadian province of Quebec from 2016 to 2019, were recruited for this cross-sectional study. Parents completed measures of their civic activities and their negative beliefs regarding youth CE. Adolescents completed measures of future civic attitudes and behaviors. RESULTS: Hierarchical regressions revealed significant positive cross-sectional associations between parental civic behaviors and their child's future civic attitudes and behaviors. However, parental negative beliefs toward youth CE were negatively associated with youths' future civic attitudes and behaviors, even after considering parental civic behaviors and family socioeconomic status. Adolescents' age did not moderate these relationships. CONCLUSION: These findings highlight the significant role that parents could play in shaping CE of future generations. Interventions promoting youth CE should thus target both adolescents and their parents.

Strengthening Youth Emotional and Behavioral Well-Being Through Community-Academic Partnership: The EMPOWER Project.

The onset of mental health issues frequently starts during adolescence, where one third of adolescents who are 14 years and younger receive a mental health diagnosis. The state of youth mental health is a major public health concern. The EMPOWER project was developed during the COVID-19 pandemic to address youth mental health. The EMPOWER project is a partnership between two after-school programs and an academic mental health hospital in Toronto, Canada, that aims to bolster youth mental well-being. In this Practice Note, we share our community-based participatory research process of how we built the EMPOWER partnership and highlight our lessons learned so far. Through EMPOWER, we aim to codesign, deliver, and evaluate a scalable, evidence-based, and community-informed youth mental wellness curriculum that will be implemented in after-school programs.

In spite of patriarchy: Pathways from school to wage work and careers among adolescent girls in Bihar.

BACKGROUND: In the context of rural Bihar where few women work outside the home, what scope do adolescent girls and young women have to transition into wage work and careers? While the mobility of girls is still widely restricted to secure their marriageability, the spread of higher schooling and the internet has inflated aspirations and levelled them out across boys, girls and social classes. METHODS: The present study drew on 45 focus group discussions and 73 in-depth interviews among adolescent girls and young women and related stakeholders to develop 32 cases of transitioning girls across four districts of rural Bihar in India. The qualitative data were collected in 2022 and analysed using a combination of thematic and comparative narrative analyses. RESULTS: The analysis identified some common features of transitioning girls and their pathways. Many girls had been forced by circumstance-household shocks or chronic poverty-to earn money, thereby building their skills and self-efficacy. Others were from families where progressive values ensured their mobility and exposure. Yet others transitioned "by stealth." But all girls had the backing of at least one parent and all had to learn to navigate public space while safeguarding their reputations. By researching actual pathways (rather than distant dreams), the study identifies a variety of transition outcomes, including "good" jobs as teachers, nurses, and police officers, "low entry" jobs in factories and new services, and full-time businesses built from scratch. CONCLUSION: The paper suggests that interventions be designed separately for these distinct outcomes and that efforts are best directed towards girls already "self-transitioning" and demonstrating the requisite resolve and self-efficacy.

Longitudinal Meta-Analysis of Peak Height Velocity in Young Female Athletes.

Growth patterns and biological milestones in youth sports are key to interpreting the development of young athletes. However, there is no analysis of longitudinal meta-analysis describing the growth of young female athletes. This longitudinal meta-analysis estimated growth curves and age at peak height velocity (PHV) in young female athletes based on anthropometric data from longitudinal studies found in the literature. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, studies with repeated measurements in young female athletes were identified from searches of four databases (MEDLINE, Web of Science, SCOPUS, and SPORTDiscus) without date restrictions through August 2023. We adapted our bias assessment criteria using the Cochrane risk of bias tool for randomized controlled trials as a reference. Bayesian multilevel modeling was used to perform a longitudinal meta-analysis to extract stature growth curves and age at PHV. Fourteen studies met our eligibility criteria. Twenty-one independent samples could be included in the analysis. Conditional on the data and models, the predicted mean age at PHV for female athletes was 11.18 years (90% CI: 8.62; 12.94). When studies were aggregated by sport in the models, the models could not capture sport-specific growth curves for stature and estimate a corresponding age at PHV. We provide the first longitudinal meta-analytic summary of pubertal growth and derive age at PHV in young female athletes. The meta-analysis predicted that age at PHV occurs at similar ages to those in the general pediatric population. The data pool was limited in sports and geographic distribution, emphasizing the need to promote longitudinal research in females across different youth sports contexts.

A Six-Year Longitudinal Study of Parenting and Depressive Symptoms among Taiwanese Adolescents.

This study investigated the associations between early parental warmth, harsh discipline, and adolescent depressive symptoms from early to late adolescence, with attention to gender differences in these associations. The sample was drawn from a longitudinal study, the Taiwan Youth Project, including 2,690 Taiwanese adolescents from wave 1 in 2000 (first year in junior high school) to wave 6 (third year in high school) in 2005. The results showed a nonlinear developmental trajectory of adolescent depressive symptoms during the middle- to high-school period. Harsh discipline was associated with the significantly higher initial presence and faster growth rate of depressive symptoms, while parental warmth and monitoring were associated with the significantly lower initial presence of depressive symptoms. In addition, female adolescents displayed a higher initial level of depressive symptoms than males when parents exercised higher levels of monitoring and harsh discipline. Finally, we provided suggestions for practice and research.

Towards a decolonial developmental science: Adolescent development in the Majority World taking center stage.

While aspiring to be a diverse and global science, developmental science continues to be dominated by EuroAmerican epistemologies, researchers, and communities in its published scholarship. Adolescents in communities across Africa, Asia, the Middle East, and Latin America comprise 85% of the world's adolescent population, and yet their experiences and perspectives are marginalized in our science. Adolescents in the Majority World live in highly diverse social, cultural, political, economic, educational and healthcare contexts that contribute to their development, and we have much to learn from their experiences. This article situates the marginalization of the global majority within coloniality embedded in developmental science. The article describes the impetus for this special issue Towards a decolonial developmental science and the process of putting it together, along with providing an overview of the 18 articles in this collection that push us towards decoloniality. The special issue serves as a call to transform developmental science to be decolonial by empowering adolescent development in Majority World communities to take center stage. Adolescent development research from Majority World communities has the potential to challenge the knowledge base generated from Minority World samples, contributing to a science that is comprehensive, inclusive, and can inform prevention and intervention efforts to support the well-being of adolescents globally.

Socioeconomic Disadvantage Moderates the Association of Systemic Inflammation With Amygdala Volume in Adolescents Over a 2-Year Interval: An Exploratory Study.

BACKGROUND: Research has demonstrated an association between elevated systemic inflammation and changes in brain function. Affective areas of the brain involved in processing threat (e.g., amygdala) and reward (e.g., nucleus accumbens) appear to be sensitive to inflammation. Early-life stress, such as experiencing low socioeconomic status (SES), may also potentiate this association, but relevant evidence has come primarily from cross-sectional studies of brain function. It is unclear whether similar associations are present between early-life stress, inflammation, and brain structure, particularly in typically developing populations. METHODS: We recruited and assessed 50 adolescents (31 females/19 males) from the community (mean [SD] age = 15.5 [1.1] years, range = 13.1-17.5 years) and examined in exploratory analyses whether changes in C-reactive protein (ΔCRP) from blood spots predict changes in gray matter volume (ΔGMV) in the bilateral amygdala and nucleus accumbens over a 2-year period. We also investigated whether experiencing early-life stress, operationalized using a comprehensive composite score of SES disadvantage at the family and neighborhood levels, significantly moderated the association between ΔCRP and ΔGMV. RESULTS: We found that ΔCRP was negatively associated with Δamygdala GMV (i.e., increasing CRP levels were associated with decreasing amygdala volume; ß = -0.84, p = .012). This effect was stronger in youths who experienced greater SES disadvantage (ß = -0.56, p = .025). CONCLUSIONS: These findings suggest that increases in systemic inflammation are associated with reductions in amygdala GMV in adolescents, potentially signaling accelerated maturation, and that these neuroimmune processes are compounded in adolescents who experienced greater SES disadvantage. Our findings are consistent with theoretical frameworks of neuroimmune associations and suggest that they may influence adolescent neurodevelopment.

Lessons Learned from Cross-Systems Approach to COVID-19 Pandemic Response in Juvenile Justice System, Colorado, USA.

The global COVID-19 pandemic illustrates the importance of a close partnership between public health and juvenile justice systems when responding to communicable diseases. Many setting-specific obstacles must be navigated to respond effectively to limit disease transmission and negative health outcomes while maintaining necessary services for youth in confinement facilities. The response requires multidisciplinary expertise and collaboration to address unique considerations. Public health mitigation strategies must balance the risk for disease against the negative effects of restrictions. Key aspects of the COVID-19 response in the juvenile justice system of Colorado, USA, involved establishing robust communication and data reporting infrastructures, building a multidisciplinary response team, adapting existing infection prevention guidelines, and focusing on a whole-person health approach to infection prevention. We examine lessons learned and offer recommendations on pandemic emergency response planning and managing a statewide public health emergency in youth confinement settings that ensure ongoing readiness.

Behavior problems, social relationships, and adolescents' future orientation. Links from middle to late adolescence.

INTRODUCTION: As adolescents leave high school, plans for the future are of great importance. Future orientation reflects positive thoughts regarding further education, employment, and family life. While future orientation has been found to affect behavior problems, the influence of behavior problems on future orientation is mainly unknown. Positive parent-child and peer relations may boost positive outlooks, but the interplay of behavior problems and social relations for future orientation remains to be studied. METHODS: Participants were 485 adolescents, 54% girls, living in Mid-Sweden. At age 15, parents and adolescents rated ADHD- and internalizing symptoms, parents rated ODD-symptoms, and adolescents rated their relationship with parents and peers. At age 18, adolescents rated future orientation regarding education, employment, and family, and reported on delinquent acts. RESULTS: Low levels of inattention symptoms and of delinquency were important for all higher future orientation aspects. In contrast, higher levels of hyperactive-impulsive symptoms were associated with more positive outlooks on work and family life. Relationships with parents and peers were stronger predictors of future outlooks, compared with behavior problems. There were few interaction effects of behavioral symptoms and social relationship quality. CONCLUSIONS: Behavior problems in middle adolescence may negatively affect future outlooks. However, positive social relations, especially relations with peers, seem more important for optimistic views than behavior problems and thus may have a compensatory effect. The clinical implications should be to address the young person's social world, in the case of misgivings about the future, also in the presence of problematic behaviors.

Aperiodic EEG and 7T MRSI evidence for maturation of E/I balance supporting the development of working memory through adolescence.

Adolescence has been hypothesized to be a critical period for the development of human association cortex and higher-order cognition. A defining feature of critical period development is a shift in the excitation: inhibition (E/I) balance of neural circuitry, however how changes in E/I may enhance cortical circuit function to support maturational improvements in cognitive capacities is not known. Harnessing ultra-high field 7 T MR spectroscopy and EEG in a large, longitudinal cohort of youth (N = 164, ages 10-32 years old, 347 neuroimaging sessions), we delineate biologically specific associations between age-related changes in excitatory glutamate and inhibitory GABA neurotransmitters and EEG-derived measures of aperiodic neural activity reflective of E/I balance in prefrontal association cortex. Specifically, we find that developmental increases in E/I balance reflected in glutamate:GABA balance are linked to changes in E/I balance assessed by the suppression of prefrontal aperiodic activity, which in turn facilitates robust improvements in working memory. These findings indicate a role for E/I-engendered changes in prefrontal signaling mechanisms in the maturation of cognitive maintenance. More broadly, this multi-modal imaging study provides evidence that human association cortex undergoes physiological changes consistent with critical period plasticity during adolescence.