COVID-19 Distress Impacts Adolescents' Depressive Symptoms, NSSI, and Suicide Risk in the Rural, Northeast US.

OBJECTIVE: Widespread concern exists about the impacts of COVID-19 and related public health safety measures (e.g., school closures) on adolescent mental health. Emerging research documents correlates and trajectories of adolescent distress, but further work is needed to identify additional vulnerability factors that explain increased psychopathology during the pandemic. The current study examined whether COVID-19-related loneliness and health anxiety (assessed in March 2020) predicted increased depressive symptoms, frequency of non-suicidal self-injury (NSSI), and suicide risk from pre-pandemic (late January/early February 2020) to June 2020. METHOD: Participants were 362 middle and high school adolescents in rural Maine (M age = 15.01 years; 63.4% female; 76.4% White). Data were collected during a time in which state-level COVID-19 restrictions were high and case counts were relatively low. Self-reports assessed psychopathology symptoms, and ecological momentary assessment (EMA) was used to capture COVID-19-related distress during the initial days of school closures. RESULTS: Loneliness predicted higher depressive symptoms for all adolescents, higher NSSI frequency for adolescents with low pre-pandemic frequency (but less frequent NSSI for adolescents with high pre-pandemic frequency), and higher suicide risk for adolescents with higher pre-pandemic risk. Health anxiety predicted higher NSSI frequency for adolescents with high pre-pandemic frequency, and secondary analyses suggested that this pattern may depend on adolescents' gender identity. CONCLUSIONS: Results underscore the impact of COVID-19 on adolescent mental health, with benefits for some but largely negative impacts for most. Implications for caretakers, educators, and clinicians invested in adolescent mental health are discussed.

Emotion regulation deficits and depression-related maladaptive interpersonal behaviours.

ABSTRACTCoyne's interpersonal theory of depression posits that those with depressive symptoms engage in maladaptive interpersonal behaviours that, although intended to assuage distress, push away social supports and increase depressive symptoms (Coyne, 1976). Excessive reassurance seeking, negative feedback seeking, and conversational self-focus are three behaviours implicated in Coyne's theory, yet their correlates- apart from depressive symptoms- are poorly understood. The current study considered the potential role of intrapersonal emotion regulation deficits as an additional vulnerability factor for these behaviours. Mediation models further tested whether linkages between emotion regulation deficits and maladaptive interpersonal behaviours helped to explain short-term increases in depressive symptoms, as further suggested by theory. Older adolescents (N = 291, M age = 18.9) completed self-report measures of emotion regulation deficits, depressive symptoms, and the three maladaptive interpersonal behaviours during an initial lab visit and again four weeks later. A series of multiple regression models suggested that emotion regulation difficulties are uniquely associated with each of the behaviours over and above the impact of depressive symptoms. Mediation analyses suggested that only excessive reassurance seeking mediated the association between initial emotion regulation deficits and increased depressive symptoms over time. The clinical implications of these findings are discussed.

Long-Term Predictive Validity of the Juvenile Sex Offender Assessment Protocol-II: Research and Practice Implications.

The current study evaluated the predictive validity of the Juvenile Sex Offender Assessment Protocol-II (J-SOAP-II) scores in a sample of juveniles who recidivated sexually or nonsexually as adults. Participants included 166 juveniles who had previously sexually offended and were followed into adulthood for an average of 10.75 years. Results of area under the receiver operating characteristic curve (AUC) analyses supported the predictive validity of the J-SOAP-II Total Score, Scale 1, and Static Score in regard to adult sexual recidivism, and predictive validity was found for all J-SOAP-II scores (except Scale 1) in regard to adult nonsexual recidivism. Implications for future research on the assessment of risk factors and treatment needs for adolescents who commit sexual offenses are discussed.

Imagery and verbal thought during rumination and distraction: Does imagery amplify affective response?

Rumination has long been considered a verbal thought process, though emerging evidence suggests that some individuals dwell on maladaptive imagery. This series of studies evaluated imagery and verbal thought during experimentally induced rumination and distraction. In Study 1, imagery and verbal thought during rumination resulted in similar increases in negative affect. Greater imagery during distraction, on the other hand, was associated with greater decreases in negative affect while verbal thought was not related to affect change. Given that greater verbal thought was reported in the rumination condition and greater imagery was reported in the distraction condition, Study 2 evaluated whether the rumination/distraction induction was confounded by concurrent induction of imagery or verbal thought. The rumination prompts induced both rumination and verbal thought and the distraction prompts induced both distraction and imagery. Using a revised induction, Study 3 tested whether imagery and verbal thought during rumination and distraction impacted affective response. Rumination maintained negative affect and distraction relieved negative affect, regardless of the degree to which imagery or verbal thought was experienced. This paper provides evidence that imagery-based rumination is just as impairing as verbally-based rumination and highlights imagery-based distraction as a potentially effective alternative to rumination.

When Does Co-Rumination Facilitate Depression Contagion in Adolescent Friendships? Investigating Intrapersonal and Interpersonal Factors.

Research supports the notion that adolescents' mental health is impacted by peers via contagion processes. A growing area of interest has been how co-rumination may influence depressive symptoms within friendships. The current study examined particular conditions under which co-rumination is especially likely to facilitate depression contagion. Participants were adolescents (N = 480, 49% female, M age = 14.6 years, 59.5% European American) paired in friendship dyads and assessed over 9 months. Characteristics of the adolescent (personal distress), of the friend (excessive reassurance seeking), and of the friendship (friendship quality) were considered. Moderated mediation analyses indicated that co-rumination facilitated depression contagion only under conditions of adolescents' high personal distress, friends' high excessive reassurance seeking, and high positive friendship quality. This research underscores the importance of attending to how and under what conditions depression contagion occurs within friendships in order to support adolescents' positive social and emotional development.

Reimagining rumination? The unique role of mental imagery in adolescents' affective and physiological response to rumination and distraction.

Rumination is associated with increased risk for depression whereas distraction helps draw attention away from negative experiences, lowering risk. Many individuals who ruminate do so in the form of mental imagery and imagery-based rumination is more highly associated with depressive symptom severity than ruminating in the form of verbal thoughts. We do not yet understand why imagery-based rumination may be especially problematic nor how to intervene to reduce imagery-based rumination, however. Adolescents (N = 145) underwent a negative mood induction followed by experimental induction of rumination or distraction in the form of mental imagery or verbal thought while affective, high-frequency heart rate variability, and skin conductance response data were collected. Rumination was associated with similar affective, high-frequency heart rate variability, and skin conductance response regardless of whether adolescents were induced to ruminate in the form of mental imagery or verbal thought. Distraction led to greater affective improvement and greater increases in high-frequency heart rate variability, but similar skin conductance responses when adolescents were inducted to distract themselves in the form of mental imagery compared with verbal thought. Findings emphasize the importance of considering mental imagery in clinical contexts when assessing rumination and when intervening using distraction.

How girls and boys expect disclosure about problems will make them feel: implications for friendships.

Although girls disclose to friends about problems more than boys, little is known about processes underlying this sex difference. Four studies (Ns = 526, 567, 769, 154) tested whether middle childhood to mid-adolescent girls and boys (ranging from 8 to 17 years old) differ in how they expect that talking about problems would make them feel. Girls endorsed positive expectations (e.g., expecting to feel cared for, understood) more strongly than boys. Despite common perceptions, boys did not endorse negative expectations such as feeling embarrassed or worried about being made fun of more than girls. Instead, boys were more likely than girls to expect to feel "weird" and like they were wasting time. Sex differences in outcome expectations did help to account for girls' greater disclosure to friends.

Suicidal Mental Imagery: Investigating a Novel Marker of Suicide Risk.

Rates of suicidal ideation and behavior are high and increasing in emerging adulthood. Research focused on suicidal ideation as a predictor of suicidal behavior has nearly exclusively conceptualized suicidal ideation as verbal thoughts about suicide. Emerging research suggests, however, that mentally imagining suicide may be even more impairing than verbal thoughts about suicide. Thirty-nine emerging adults with a lifetime history of suicidal cognitions completed self-report assessments of characteristics of their suicidal cognitions, histories of suicide plans and behavior, and the degree to which their suicidal cognitions took the form of mental imagery or verbal thought. Suicidal mental imagery predicted more intense and longer duration of suicidal cognitions, a higher likelihood of having made a suicide plan, and a higher likelihood of having made a suicide attempt over and above suicidal verbal thoughts. Thus, suicidal mental imagery could provide a novel target for suicide assessment and intervention for emerging adults.

Friends' discussions of interpersonal and noninterpersonal problems during early and middle adolescence: Associations with co-rumination.

Friendships are important sources of support during adolescence. However, a growing literature indicates some adolescents co-ruminate, or talk with friends about problems in a way that is excessive, speculative, and negatively focused, which confers risk for internalizing problems. Still, previous research had not examined the types of problems co-ruminators discuss. Using self-reported co-rumination and observations of friends' conversations about problems, the present study of early and middle adolescents addressed this gap. Participants (N = 628) were approximately half female (52% of the sample) and primarily European American and African American (63% and 29% of the sample, respectively). Adolescents who reported greater co-rumination spent more time discussing interpersonal problems with friends, including problems with families, peers, and romantic interests. Interpersonal problems may lend themselves to co-rumination because they can be ambiguous, multifaceted, and difficult to resolve. In contrast, co-rumination was not related spending more time discussing noninterpersonal problems. In addition, middle adolescents were observed to spend more time than early adolescents discussing problems related to developmentally salient tasks (e.g., romantic relationships, academics), and girls spent more time than boys discussing interpersonal problems. Taken together, the findings contribute to a more comprehensive understanding of co-rumination. Moreover, the study has applied implications in that findings suggest that adolescents experiencing interpersonal problems may be at elevated risk of co-ruminating. In addition to steering these adolescents away from co-rumination, fostering better problem-solving skills for interpersonal problems may lead to the resolution of these problems before they become topics of co-rumination. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Social-cognitive risk for suicide and new relationship formation: False perception, self-fulfilling prophecy, or both?

OBJECTIVE: This study examined the impact of social-cognitive constructs associated with increased suicide risk (i.e., perceived burdensomeness and thwarted belongingness) on relationship formation during real-time interactions of older adolescents with strangers in a dyadic context. METHOD: Two hundred and seventy-four older adolescents (61.9% female, M age = 18.96 years) were paired with same-gender strangers and completed a laboratory-based interaction task. Both target participants and their partners answered questions about their interaction at three time points during the 45-min session. Structural equation modeling was used to test hypothesized models. RESULTS: Perceived burdensomeness and thwarted belongingness predicted interpersonal consequences during the interaction. In the first model, thwarted belongingness led targets to inaccurately perceive their partners' assessments of the interaction. This misperception negatively impacted the participants' own desires for friendship. In the second model, thwarted belongingness predicted decreases in targets' desire to continue the conversation, whereas perceived burdensomeness predicted higher levels of desire to continue the conversation. For females, thwarted belongingness in particular was related to new relationship formation in these models. Overall, those who desired to continue talking were more likely to like their partner at the end of the conversation. CONCLUSIONS: Results add to our understanding of how perceived burdensomeness and thwarted belongingness contribute to increased social alienation, which could serve to increase suicide risk.

Intrapersonal Emotion Regulation Difficulties and Maladaptive Interpersonal Behavior in Adolescence.

Although most research conceptualizes emotion regulation as an internal process (i.e., intrapersonal), emotions are frequently regulated in an interpersonal context. Adolescents may be particularly prone to turn to peers for assistance, given that honing emotion regulation abilities is a key task and peers become increasingly important at this stage. Adolescents each participated with a self-nominated same-gender friend (total N = 186; M age = 15.68 years). All participants provided self-reports of their own emotion regulation difficulties and their engagement in interpersonal behaviors (excessive reassurance seeking, negative feedback seeking, conversational self-focus, self-disclosure) as well as their perceptions of their friends' engagement in excessive reassurance seeking and conversational self-focus. Using a cross-lagged panel model design, the current study tested associations between adolescents' intrapersonal emotion regulation difficulties and engagement in self- and friend-reported interpersonal emotion regulation behaviors at 3 time points over 6 months. Gender and age group differences were considered. Results evidenced concurrent and longitudinal associations between emotion regulation difficulties and self-reported maladaptive (excessive reassurance seeking, conversational self-focus, negative feedback seeking), but not adaptive (self-disclosure), interpersonal regulatory behaviors. Friends' reports of adolescents' excessive reassurance seeking and conversational self-focus were associated concurrently, but not longitudinally, with self-reported emotion regulation difficulties. Implications for clinical intervention with adolescents struggling to regulate emotions are discussed.

Relations of friendship experiences with depressive symptoms and loneliness in childhood and adolescence: A meta-analytic review.

Well-established psychological theories indicate that interpersonal relationships and emotional well-being are linked in fundamental ways (Coyne, 1976; Sullivan, 1953). Indeed, difficulties in close relationships can contribute to emotional adjustment problems, and emotional problems can adversely affect close relationships. Moreover, different close relationships are especially significant in terms of development and adjustment at different stages of the life span. The current review focuses on childhood and adolescence, developmental stages at which friendships are particularly important. This article presents the results of 16 meta-analyses including 589 unique effects from 233 studies that examine concurrent and longitudinal associations between youths' friendship experiences (number of friends, positive friendship quality, negative friendship quality) and their emotional adjustment (depressive symptoms and loneliness). Studies examining these associations are mixed in regard to whether significant effects emerge. The current research synthesis provides more stable estimates of the effects. In fact, relatively small but significant concurrent and longitudinal associations emerged between the 3 indices of friendship with depressive symptoms and loneliness. The results also suggest that friendship experiences may be more closely linked with loneliness than depressive symptoms and that negative friendship quality may be related to friendship experiences more strongly than number of friends or positive friendship quality. Interestingly, some of the relations were found to be stronger for younger youth. Implications for prevention and intervention efforts are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Conversational Self-Focus in Adolescent Friendships: Observational Assessment of an Interpersonal Process and Relations with Internalizing Symptoms and Friendship Quality.

Although youth with internalizing symptoms experience friendship difficulties, surprisingly little is known about their problematic interpersonal behaviors. The current observational study identifies a new construct, conversational self-focus, defined as the tendency to direct the focus of conversations to the self and away from others. Results indicated that youth with internalizing symptoms were especially likely to engage in self-focus when discussing problems with friends and that doing so was related to their friends perceiving the relationship as lower in quality, particularly helping. Content analyses further indicated that self-focused youth talked about themselves in ways that were distracting from their friends' problems and that they changed the subject abruptly. Last, conversational self-focus was not redundant with related constructs of rumination and self-disclosure. This research highlights the importance of intervention efforts aimed at teaching self-focused youth ways to cope with distress that are more effective and will not damage their friendships.

Peer Socialization of Non-Suicidal Self-Injury in Adolescents' Close Friendships.

Non-suicidal self-injury (NSSI), or self-harming behavior without intent to die (Nock Current Directions in Psychological Science, 18, 78-83, 2009), is associated with distress and impairment across domains, including increased risk for suicidality (Kiekens et al. Journal of Affective Disorders, 239, 171-179, 2018). In adolescence, prevalence of NSSI is high (Swannell et al. Suicide and Life-threatening Behavior, 44, 273-303, 2014), and peer influence regarding NSSI is thought to be strong (Brechwald and Prinstein Journal of Research on Adolescence, 21, 166-79, 2011). Although concern regarding "clusters" of NSSI has long been documented, peer socialization of NSSI in adolescence is understudied. This paper tests peer influence on NSSI frequency within adolescent friendship dyads. Emotion regulation difficulties and friendship quality were evaluated as factors that may influence susceptibility to peer influence effects. Adolescents (N = 196, M age = 15.68, 69.9% female, 87.6% White) nested within 93 friendship dyads reported on their own NSSI frequency, difficulties in emotion regulation, and friendship quality at three time points spaced 3 months apart. Cross-lagged Actor-Partner Interdependence Models examined peer influence effects over time. Friends' Time 1 frequency of NSSI uniquely predicted adolescents' own NSSI frequency over 3 and 6 months, controlling for initial similarity among friends as well as individual risk factors for NSSI. Peer influence effects were strongest in adolescents with higher levels of emotion regulation difficulty but did not vary as a function of friendship quality. Friends' NSSI frequency is a significant and unique predictor of increases in adolescents' own NSSI frequency over time. Implications for interventions that leverage the important developmental context of peer relationships are discussed.

Social-Cognitive and Social-Behavioral Correlates of Suicide Risk in College Students: Contributions from Interpersonal Theories of Suicide and Depression.

Joiner's interpersonal-psychological theory of suicide (IPTS) is predated by literature examining maladaptive interpersonal behaviors associated with depression; however, research has not examined the potential relevance of such behaviors for the IPTS. The current study aimed to expand understanding of suicide risk by examining two maladaptive interpersonal behaviors in the context of Joiner's IPTS model. Structural equation modeling examined associations between depressive symptoms, social-cognitive predictors of suicide, maladaptive interpersonal behaviors, and suicide risk in 228 college students (53.9% female; M = 19.5 years, SD = 1.8). Social-cognitive IPTS variables mediated the relation between depressive symptoms and maladaptive interpersonal behavior. Both social-cognition and maladaptive interpersonal behavior mediated the effect of depressive symptoms on suicide risk. Findings have the potential to add to our understanding of the interplay of social-cognitive factors and interpersonal behaviors associated with suicide risk. Directions for future research are discussed.

Co-Rumination Exacerbates Stress Generation among Adolescents with Depressive Symptoms.

Through stress generation, individuals' own thoughts and behaviors can actually lead to increases in their experience of stress. Unfortunately, stress generation is especially common among individuals who are already suffering from elevated depressive symptoms. However, despite the acknowledgement that some individuals with depressive symptoms generate greater stress than others, few studies have identified specific factors that could exacerbate stress generation among individuals with depressive symptoms. The present study examines co-rumination as a factor that might exacerbate stress generation among adolescents with depressive symptoms using a short-term longitudinal design. Considering these processes among adolescents was critical given that many youth experience increases in depressive symptoms at this developmental stage and that co-rumination also becomes more common at adolescence. Participants were 628 adolescents (326 girls; 302 boys) who reported on their depressive symptoms, experiences of stress, and co-rumination with a best friend. Interpersonal stressors (peer and family stress) and non-interpersonal stressors (school and sports stress) were assessed. Consistent with past research, adolescents with depressive symptoms experienced greater interpersonal and non-interpersonal stress over time. Importantly, co-rumination interacted with both depressive symptoms and gender in predicting increases in peer stress. Depressive symptoms predicted the generation of peer stress only for girls who reported high levels of co-rumination with friends. Implications for protecting youth with depressive symptoms against stress generation are discussed.

Depressive Symptoms and Conversational Self-Focus in Adolescents' Friendships.

This multi-method, longitudinal study considered the interplay among depressive symptoms, aversive interpersonal behavior, and interpersonal rejection in early and middle adolescents' friendships. In particular, the study examined a newly identified interpersonal process, conversational self-focus (i.e., the tendency to redirect conversations about problems to focus on the self). Traditional interpersonal theories of depression suggest that individuals with depressive symptoms engage in aversive behaviors (such as conversational self-focus) and are rejected by others. However, in the current study, not all adolescents with depressive symptoms engaged in conversational self-focus and were rejected by friends. Instead, conversational self-focus moderated prospective relations of depressive symptoms and later friendship problems such that only adolescents with depressive symptoms who engaged in conversational self-focus were rejected by friends. These findings are consistent with current conceptualizations of the development of psychopathology that highlight heterogeneity among youth who share similar symptoms and the possibility of multifinality of outcomes.

Girls' and boys' problem talk: Implications for emotional closeness in friendships.

This research highlights the critical role of gender in the context of problem talk and social support in adolescents' friendships. Early- and middle-adolescents' (N = 314 friend dyads; Ms = 13.01 and 16.03 years) conversations about problems were studied using observation and a short-term longitudinal design. Mean-level gender differences emerged in that girls participated in problem talk more than boys and responded in a more positive and engaged manner to friends' statements about problems (e.g., by saying something supportive, asking a question) than did boys. Interestingly, boys used humor during problem talk more than girls. Despite mean-level differences, there were not gender differences in the functional significance of participating in problem talk and positive engaged responses in that these behaviors predicted increased friendship closeness for both boys and girls. In contrast, humor during problem talk predicted increased closeness only for boys, highlighting an understudied pathway to closeness in boys' friendships.

An observational study of co-rumination in adolescent friendships.

Co-rumination is a dyadic process between relationship partners that refers to excessively discussing problems, rehashing problems, speculating about problems, mutual encouragement of problem talk, and dwelling on negative affect. Although studies have addressed youths' tendency to co-ruminate, little is known about the nature of co-ruminative conversations. The primary goal of the present study (N = 314 adolescent friend dyads) was to identify microsocial processes that sustain and reinforce problem talk among adolescent co-ruminating friends. Results indicated that co-rumination was characterized by friends responding to each other's statements about problems with engaged statements (e.g., questions, supportive statements) that elicited even more problem talk. Results also indicated that some aspects of co-rumination (i.e., extensively talking about problems, rehashing problems, speculating about problems, and mutual encouragement of problem talk) were associated with positive friendship adjustment, whereas other aspects (i.e., dwelling on negative affect) were associated with internalizing problems. The present research highlights the utility of attending to microsocial processes in friends' conversations and has implications for intervention.

Co-rumination mediates contagion of internalizing symptoms within youths' friendships.

Peer contagion of internalizing symptoms was examined within youths' friendships over 6 months. Children (Grades 3 and 5) and adolescents (Grades 7 and 9) paired in 274 reciprocal same-sex friendship dyads completed measures of depressive and anxiety symptoms, co-rumination, and self-disclosure. Depression contagion was present for all youth, and anxiety contagion was found in the sample of girls and older boys. Although normative self-disclosure did not mediate the contagion effects, co-rumination mediated the depression contagion effect for adolescents and the anxiety contagion effect in the sample of girls and older boys. Implications for interventions with youth at risk for developing internalizing symptoms are discussed.