The codevelopment of adolescents' and parents' anxiety and depression: Moderating influences of youth gender and psychophysiology.

METHODS: In a 2-year longitudinal study of 220 families, we examined how youth gender and adrenocortical and parasympathetic activity moderated reciprocal, bidirectional relations between parent and youth anxiety and depression problems. RESULTS: Maternal anxiety predicted subsequent youth anxiety and depression. Maternal depression predicted youth anxiety and, for daughters and youth with low adrenocortical reactivity, youth depression. Youth depression predicted maternal depression only for youth with high adrenocortical reactivity. There were no associations between paternal and youth psychopathology. DISCUSSION: Examining youth gender and psychophysiological characteristics that shape the nature of bidirectional influences may inform efforts to identify families at heightened risk for intergenerational transmission of psychopathology.

Family Thriving During COVID-19 and the Benefits for Children's Well-Being.

Although the COVID-19 pandemic has raised deserved concern regarding adverse impacts on parents' and children's mental health, regulations like "sheltering-in-place" may have afforded parents novel opportunities to foster positive family connections, thereby bolstering well-being. Using latent profile analysis (LPA), we (a) distinguished family thriving during shelter-in-place (May-June 2020) from other patterns of family functioning, (b) tested potential predictors of family functioning profiles, and (c) examined if family thriving predicted subsequent child adjustment (September-October 2020). 449 parents in two-parent U.S. families with children aged 2-18 years completed online surveys assessing (a) parent-child relationship quality, parents' positive psychological adjustment, children's emotional well-being, and parenting efficacy and satisfaction as family functioning indicators, (b) financial, marital, parental psychosocial assets, and child (age, gender, and temperament) predictors of family functioning, and (c) child adjustment. LPA identified four family functioning profiles: Thriving, Managing, Struggling, and Distressed. Thriving families evinced higher scores on all functioning indicators. Logistic regressions revealed that parents in Thriving families reported significantly lower financial anxiety, less dissatisfaction with partner's help, less child emotionality, and greater use of cognitive reappraisal, as well as more positive child adjustment in Fall 2020. These findings underscore the multidimensional nature of coping and well-being during COVID-19. Utilizing these levers to promote mental health in families languishing during comparable future crises could promote resilience, thereby protecting children's well-being.

Effect of Light Flashes vs Sham Therapy During Sleep With Adjunct Cognitive Behavioral Therapy on Sleep Quality Among Adolescents: A Randomized Clinical Trial.

Importance: Owing to biological, behavioral, and societal factors, sleep duration in teenagers is often severely truncated, leading to pervasive sleep deprivation. Objective: To determine whether a novel intervention, using both light exposure during sleep and cognitive behavioral therapy (CBT), would increase total sleep time in teenagers by enabling them to go to sleep earlier than usual. Design, Setting, and Participants: This double-blind, placebo-controlled, randomized clinical trial, conducted between November 1, 2013, and May 31, 2016, among 102 adolescents enrolled full-time in grades 9 to 12, who expressed difficulty going to bed earlier and waking up early enough, was composed of 2 phases. In phase 1, participants were assigned to receive either 3 weeks of light or sham therapy and were asked to try to go to sleep earlier. In phase 2, participants received 4 brief CBT sessions in addition to a modified light or sham therapy. All analyses were performed on an intent-to-treat basis. Interventions: Light therapy consisted of receiving a 3-millisecond light flash every 20 seconds during the final 3 hours of sleep (phase 1) or final 2 hours of sleep (phase 2). Sham therapy used an identical device, but delivered 1 minute of light pulses (appearing in 20-second intervals, for a total of 3 pulses) per hour during the final 3 hours of sleep (phase 1) or 2 hours of sleep (phase 2). Light therapy occurred every night during the 4-week intervention. Cognitive behavioral therapy consisted of four 50-minute in-person sessions once per week. Main Outcomes and Measures: Primary outcome measures included diary-based sleep times, momentary ratings of evening sleepiness, and subjective measures of sleepiness and sleep quality. Results: Among the 102 participants (54 female [52.9%]; mean [SD] age, 15.6 [1.1] years), 72 were enrolled in phase 1 and 30 were enrolled in phase 2. Mixed-effects models revealed that light therapy alone was inadequate in changing the timing of sleep. However, compared with sham therapy plus CBT alone, light therapy plus CBT significantly moved sleep onset a mean (SD) of 50.1 (27.5) minutes earlier and increased nightly total sleep time by a mean (SD) of 43.3 (35.0) minutes. Light therapy plus CBT also resulted in a 7-fold greater increase in bedtime compliance than that observed among participants receiving sham plus CBT (mean [SD], 2.21 [3.91] vs 0.29 [0.76]), as well as a mean 0.55-point increase in subjective evening sleepiness as compared with a mean 0.48-point decrease in participants receiving sham plus CBT as measured on a 7-point sleepiness scale. Conclusions and Relevance: This study found that light exposure during sleep, in combination with a brief, motivation-focused CBT intervention, was able to consistently move bedtimes earlier and increase total sleep time in teenagers. This type of passive light intervention in teenagers may lead to novel therapeutic applications. Trial Registration: ClinicalTrials.gov identifier: NCT01406691.