[Predictor variables of contraceptive method use in young people: A systematic review]. / Variables predictoras del uso de los métodos anticonceptivos en jóvenes: una revisión sistemática.

OBJECTIVE: To analyse predictor variables of contraceptive method use in young people. DESIGN: Systematic review. DATA SOURCES: PubMed, CINAHL, Scopus, Cuiden Plus, LILACS and IME databases were consulted. STUDY SELECTION: An assessment of the quality of studies was carried out by two researchers in parallel. As a result, a total of 5 primary research studies were selected. DATA EXTRACTION: Information was extracted on the selected study population, contraceptive method studied and predictor variables identified. RESULTS: Seven predictor variables were identified that specifically explain the use of the male condom, contraceptive pill or emergency contraceptive pill. The most relevant variables were the level of knowledge and attitudes towards contraceptive use, therefore high knowledge and positive attitudes increase the likelihood of contraceptive use. Another notable finding was the presence of a formative bias with women having higher knowledge of hormonal contraceptive options and more positive attitudes. CONCLUSION: Future training programs should be oriented towards assessing behavioral changes through the development of positive attitudes towards contraceptive use by gaining knowledge of contraceptive options.

Safe haven in adolescence: Improving parental reflective functioning and youth attachment and mental health with the Connecting and Reflecting Experience.

Attachment security provides a well-documented protective developmental function for children exposed to individual- and community-level trauma, yet the effectiveness of prevention and intervention efforts targeting attachment during adolescence has been relatively underexplored. The Connecting and Reflecting Experience (CARE) program is a transdiagnostic, bi-generational, group-based, mentalizing-focused parenting intervention developed to dismantle the intergenerational transmission of trauma and support secure attachment relationships across the developmental spectrum within an under-resourced community. This exploratory study evaluated outcomes among caregiver-adolescent dyads (N = 32) in the CARE condition of a nonrandomized clinical trial at an outpatient mental health clinic within a diverse, urban U.S. community with disproportionate trauma exposure exacerbated by COVID-19. Caregivers predominantly identified as Black/African/African American (47%), Hispanic/Latina (38%), and/or White (19%). At pre- and post-intervention, caregivers completed questionnaires regarding parental mentalizing and their adolescents' psychosocial functioning. Adolescents completed scales regarding attachment and psychosocial functioning. Results showed a significant decrease in caregivers' prementalizing on the Parental Reflective Functioning Questionnaire, improvement in adolescent psychosocial functioning on the Youth Outcomes Questionnaire, and an increase in adolescents' reports of attachment security on the Security Scale. These preliminary findings suggest that mentalizing-focused parenting interventions may be effective in fostering improved attachment security and psychosocial functioning during adolescence.

La seguridad de la afectividad provee una bien documentada función protectora del desarrollo para niños expuestos al trauma individual y comunitario; aun así, la efectividad de los esfuerzos de prevención e intervención enfocados en la afectividad en la adolescencia ha sido relativamente poco explorada. El programa Conexión y Reflexión de la Experiencia (CARE) es una intervención de crianza transdiagnóstica, bigeneracional, con base en el grupo, enfocada en la mentalización, desarrollada para desarmar la transmisión intergeneracional de trauma y apoyar las relaciones de afectividad segura a lo largo del espectro del desarrollo dentro de una comunidad menos equipada con recursos. Este estudio exploratorio evaluó resultados entre díadas cuidador-adolescente (N = 32) bajo la condición CARE de un ensayo clínico no al azar en una clínica de salud mental ambulatoria dentro de una comunidad diversa y urbana en Estados Unidos, expuesta al trauma desproporcionadamente, lo cual fue exacerbado por COVID-19. A los cuidadores predominantemente se les identificó como negros/africanos/afroamericanos (47%), hispanos/latinas (38%), y/o blancos (19%). Antes y después de la intervención, los cuidadores completaron cuestionarios acerca de mentalización del progenitor y el funcionamiento sicosocial de sus adolescentes. Los adolescentes completaron escalas sobre la afectividad y el funcionamiento sicosocial. Los resultados mostraron una significativa disminución de la pre-mentalización en el Cuestionario del Funcionamiento con Reflexión del Progenitor, mejoras en el funcionamiento sicosocial de los adolescentes en el Cuestionario de Resultados de la Juventud, y un aumento en los reportes de los adolescentes sobre la seguridad de la afectividad en la Escala de Seguridad. Estos preliminares resultados sugieren que las intervenciones de crianza enfocadas en la mentalización pudieran ser efectivas para fomentar la mejorada seguridad de la afectividad y el funcionamiento sicosocial durante la adolescencia.

La sécurité de l'attachement offre une fonction protectrice au développement qui est bien prouvée pour les enfants exposés à un trauma individuel et communautaire. Cependant l'efficacité de la prévention et des efforts d'intervention ciblant l'attachement durant l'adolescence a été relativement peu exploré. Le programme de Connecting and Reflecting Experience (CARE, soit Expérience de Lien et de Réflexion) est une intervention de parentage transdiagnostique, bi-générationnel, basée sur un groupe, et ciblé sur la mentalisation développé afin de démonter la transmission intergénérationnelle du trauma et de soutenir des relations d'attachement sécure au travers du spectre développemental au soin d'une communauté manquant de moyens. Cette étude exploratoire a évalué les résultats chez des dyades personne prenant soin de l'adolescent-adolescent (N = 32) dans la condition CARE d'un essai clinique non-randomisé dans une clinique de santé mentale en consultation externe au soin d'une communauté américaine urbaine et diverse avec une exposition au trauma disproportionnée exacerbée par le COVID-19. Les personnes prenant soin des adolescents se sont en grande partie identifiés comme étant Noirs/Africains/Noir Américains (47%), Hispaniques/Latina (38%), et/ou Blanches (19%). Avant et après l'intervention les personnes prenant soin des adolescents ont rempli des questionnaires concernant la mentalisation parentale et le fonctionnement psychosocial de leurs adolescents. Les adolescents ont rempli des échelles concernant l'attachement et le fonctionnement psychosocial. Les résultats montrent une baisse importante de la pré-mentalisation des personnes prenant soin des adolescents concernant le Questionnaire de Fonctionnement de Réflexion Parental, une amélioration du fonctionnement psychosocial de l'adolescent au travers du Questionnaire des Résultats de Jeunesse (Youth Outcomes Questionnaire en anglais) et une augmentation dans les rapports de sécurité d'attachement faits par les adolescents au travers de l'échelle Security Scale. Ces résultats préliminaires suggèrent que les interventions de parentage focalisées sur la mentalisation peuvent être efficaces pour favoriser une sécurité de l'attachement améliorée et le fonctionnement psychosocial durant l'adolescence.

Internalizing and externalizing behaviors in high school adolescents in a northern border city of Mexico and their type of family.

OBJECTIVE: Identify externalizing and internalizing behaviors in high school adolescents in three schools in a northern border city in Mexico and their type of family. DESIGN: Cross-sectional survey. LOCATION: Three schools in the city of Tijuana, Mexico: two public and one private. PARTICIPANTS: 454 baccalaureate students 14-19 years old. MAIN MEASUREMENTS: We utilized Youth Self Report Scale, adapted and validated in Spanish, that measure internalization behaviors (anxiety, depression, isolation or somatic complaints), and externalization behaviors (verbal aggressiveness, delinquent behavior and attention-seeking). For dichotomous discrimination between deviant and nondeviant scores, we use the borderline clinical range by classifying YSR scale's T scores≥60, and to analyze the relationship between behavior problems or competencies and living or not in a nuclear family we utilized multiple logistic regression. RESULTS: 55% were female, mean age 16.4 years±0.98, and 62.3% came from a nuclear family. Prevalence of internalizing behaviors was 15.6%, and externalizing behaviors 14.8%. Women had statistically higher mean scores in depressive, anxious and verbally aggressive behavior, somatic complaints, and thought problems. The prevalence of internalizing behaviors in adolescents with nuclear family was 11.7% (n=33), and for adolescents with another type of family was 22.2% (n=38), OR 2.17 (CI 95% 1.30-3.61, p=0.003), but no differences was observed for externalizing behaviors and family type. When adjusted for sex, age, and public or private school, internalizing behaviors and specifically depressive behavior remained significant. CONCLUSIONS: We detected a moderate prevalence of internalizing behaviors in Mexican adolescents, predominantly among women, and also observed that not living with a nuclear family increases the odds of presenting internalizing behaviors. It is important that parents, teachers, and healthcare workers remain vigilant to detect these problems in a timely manner and develop interventions to improve the mental health and well-being of adolescents.

Adolescent Attachment: A Social Relations Perspective on Family Relations.

While attachment at an early age is almost exclusively determined by parental behavior, variation in the quality of attachment in adolescence seems strong to be influenced by the complex interplay between the adolescent's internal working model and its environment. To unravel the different sources of variance in adolescent attachment relationships we applied the Social Relations Model. Two parents and two adolescents from 70 relatively well-functioning families reported on their attachment relationships within a family context. In this study, attachment was conceptualized by two different dimensions of attachment, namely anxiety (for being abandoned) and avoidance (of intimacy). Our findings suggest adolescents experience little attachment anxiety throughout adolescence, but they report significantly more attachment avoidance toward their parents. The variance in the quality of adolescents' attachment relationships was mainly determined by characteristics of the adolescent and the unique adjustments they make to the attachment figure.

Si bien el apego en los primeros años de vida está casi exclusivamente determinado por la conducta de los padres, la variación de la calidad del apego en la adolescencia parece significativamente influenciada por la interacción compleja entre el modelo de funcionamiento interno del adolescente y su entorno. Para descifrar las diferentes fuentes de varianza en las relaciones de apego de los adolescentes, aplicamos el modelo de relaciones sociales. Dos padres y dos adolescentes de 70 familias con un funcionamiento relativamente bueno informaron sobre sus relaciones de apego dentro de un contexto familiar. En este estudio, el apego se conceptualizó mediante dos aspectos diferentes del apego, por ejemplo, la ansiedad (por ser abandonado) y la evitación (de la intimidad). Nuestros resultados sugieren que los adolescentes sufren poca ansiedad por el apego durante la adolescencia, pero informan una evitación del apego más significativa hacia sus padres. La varianza en la calidad de las relaciones de apego de los adolescentes estuvo determinada principalmente por las características del adolescente y por las adaptaciones únicas que hace a la figura de apego.

Intervention effects on self-control decrease speed of biological aging mediated by changes in substance use: A longitudinal study of African American youth.

Biological aging is a common root for multiple diseases causing morbidity and mortality, and trajectories of aging may start early in life. This study was designed to examine whether a universal family-based substance use preventive intervention to enhance self-control and reduce substance use would also result in reductions in biological aging among Black youth from the rural South. The Adults in the Making (AIM) program is a randomized controlled trial with six 2-h sessions for Black youth. The 216 youths agreeing to provide blood at age 22 included 114 who had received the AIM intervention and 102 who assigned to the control group. We examined accelerated DNA methylation (DNAm)-based aging using a recently developed measure, "GrimAge," that has been shown to predict the risk of early mortality and that is known to be more strongly affected by substance use than other DNAm-based aging indices. Relative to those randomly assigned to the control group, those receiving the intervention demonstrated significantly enhanced self-control, slower increases in substance use, and reduced Grim aging at age 22. Using a bootstrapping method with 1000 replications, we found a significant indirect effect of AIM on reduced Grim aging through its effect on self-control and substance use. Sensitivity analyses examined effects using other indices of DNAm-based aging. These findings suggest that a family-based program designed to enhance rural Black youth's self-control can have beneficial effects on self-control, enhancing young adult health and health behavior, and ultimately decreased mortality risk.

El envejecimiento biológico es una causa común de varias enfermedades que causan morbilidad y mortalidad, y las trayectorias del envejecimiento pueden comenzar en las primeras etapas de la vida. Este estudio se diseñó para analizar si una intervención preventiva familiar y universal en el abuso de sustancias orientada a mejorar el autocontrol y a reducir el consumo de sustancias también tendría como resultado disminuciones del envejecimiento biológico entre jóvenes negros del sur rural. El programa Adults in the Making (AIM) es un ensayo controlado aleatorizado con seis sesiones de dos horas para jóvenes negros. Entre los 216 jóvenes que aceptaron dar sangre a los 22 años se encontraban 114 que habían recibido la intervención del AIM y 102 asignados al grupo de referencia. Analizamos el envejecimiento basado en la metilación acelerada del ADN (ADNm) usando un método de medición desarrollado recientemente que se llama "GrimAge", el cual, según se ha demostrado, predice el riesgo de mortalidad temprana y está más marcadamente afectado por el consumo de sustancias que otros índices de envejecimiento basados en el ADNm. En relación con las personas asignadas aleatoriamente al grupo de referencia, las que recibieron la intervención demostraron un autocontrol considerablemente mayor, aumentos más lentos de consumo de sustancias y un menor envejecimiento Grim a los 22 años. Utilizando un método de muestreo con reemplazamiento con 1000 reproducciones, hallamos un efecto indirecto significativo del AIM en un menor envejecimiento Grim mediante su efecto en el autocontrol y el consumo de sustancias. Los análisis de sensibilidad examinaron los efectos utilizando otros índices de envejecimiento basados en el ADNm. Estos resultados indican que un programa familiar diseñado para aumentar el autocontrol de los jóvenes negros de zonas rurales puede tener efectos beneficiosos en el autocontrol, mejorar la salud de los adultos jóvenes y su conducta con respecto a la salud y, finalmente, disminuir el riesgo de mortalidad.

Parents' Beliefs, Depressive Symptoms, and Emotion Regulation Uniquely Relate to Parental Responses to Adolescent Positive Affect.

Parents' socialization of positive affect is relevant during adolescence, given that parents play a key role in the development of youth emotional competency. The current study hypothesized that parent characteristics (emotion regulation, belief that positive emotions are costly, and depressive symptoms) would be uniquely related to both dampening and enhancing responses to youth positive affect. Parents (n = 373) of adolescents (youth ages 10-17 years) were recruited through Amazon Mechanical Turk. Parents reported on their own regulation of both positive and negative emotions, depressive symptoms, beliefs about youth emotions, and responses to adolescent expressions of positive affect. The final structural regression model partially supported the hypothesis with respect to parental dampening responses. Depressive symptoms, over-controlled emotion regulation, and beliefs about positive emotions each uniquely related to dampening. Only the coping emotion regulation strategies factor was uniquely associated with parents' enhancing responses. These findings support existing theories of parental emotion socialization, though the final model in this sample provides more insight into parental dampening than parental enhancing responses to positive affect. The finding that emotion regulation strategies (over-controlled and coping) were differentially related to parental responses to youth positive affect suggests a connection between parents' regulation of their own emotions and responses to their offspring's emotion expressions.

La socialización del afecto positivo de los padres es de interés durante la adolescencia, dado que los padres desempeñan un papel clave en el desarrollo de la competencia emocional de los jóvenes. En el presente estudio se planteó la hipótesis de que las características de los padres (la regulación emocional, la creencia de que las emociones positivas son perjudiciales, y los síntomas depresivos) estarían particularmente relacionadas tanto con respuestas atenuadoras como intensificadoras al afecto positivo de los jóvenes. Se convocó a padres (n = 373) de adolescentes (edades de los jóvenes: entre 10 y 17 años) mediante Amazon Mechanical Turk. Los padres informaron sobre su propia regulación de emociones positivas y negativas, síntomas depresivos, creencias acerca de las emociones de los jóvenes y respuestas a las expresiones de afecto positivo de los adolescentes. El modelo de regresión estructural final respaldó parcialmente la hipótesis con respecto a las respuestas de atenuación de los padres. Los síntomas depresivos, la regulación emocional sobrecontrolada y las creencias acerca de las emociones positivas se relacionan cada una particularmente con la atenuación. Solo el factor de afrontamiento de las estrategias de regulación emocional estuvo asociado particularmente con las respuestas intensificadoras de los padres. Estos resultados respaldan las teorías actuales de socialización emocional de los padres, aunque el modelo final de esta muestra profundiza más en las respuestas de atenuación parental que en las de intensificación parental al afecto positivo. El hallazgo de que las estrategias de regulación emocional (sobrecontroladas y de afrontamiento) se relacionaron de manera diferente con las respuestas de los padres al afecto positivo de los jóvenes indica una conexión entre la regulación de los padres de sus propias emociones y las respuestas a las expresiones emocionales de sus hijos.

[Prevention of mental health disorders in primary care: Pregnancy in adolescence]. / Prevención de los trastornos de la salud mental. Embarazo en la adolescencia.

Adolescent pregnancy is generally an unwanted pregnancy, a situation that involves significant biological, psychological and social overloads, with repercussions on the health of the mother and the child. But the psychosocially important fact is that an unwanted pregnancy in its entirety gives rise to the birth of an ambivalently wanted child, a high-risk child. Those born in Spain in 2020 to women under 20 years of age were 8,305, which corresponds to 1.97% of all births. This review presents measures and recommendations for the protection and prevention of the mental health of the mother and child when pregnancy takes place in adolescence.

A Latent Profile Analysis of the Parent-Adolescent Relationship: Assessing Both Parent and Adolescent Outcomes.

Using family systems and attachment theory frameworks, this study identified specific dimensions of the parent-adolescent relationship and examined the association between those dimensions and adolescent depression and delinquency, and parental depression 2 years later in a racially and ethnically diverse sample. Parent-adolescent relationships were identified using a person-centered approach, latent profile analysis, using closeness, communication, conflict, and autonomy as dimensions of the relationship. The latent profile analysis produced a four-profile solution, which was labeled secure, avoidant, anxious, and detached. Next, parent and adolescent outcomes were examined. Results indicated that adolescents in the detached profile exhibited the highest amount of delinquency, whereas the parents exhibited the lowest amount of depression. Adolescents in the avoidant profile also exhibited high levels of delinquency, and parents in this profile also exhibited the highest amount of depression symptoms. No profile differences were found for adolescent depression symptoms. Implications for family interventions are discussed.

Utilizando los marcos de los sistemas familiares y la teoría del apego, este estudio identificó las dimensiones específicas de la relación entre padres e hijos adolescentes y analizó la asociación entre esas dimensiones y la delincuencia y la depresión en los adolescentes, así como la depresión de los padres dos años después en una muestra diversa a nivel racial y étnico. Se identificaron las relaciones entre padres e hijos utilizando un enfoque centrado en la persona y un análisis de perfiles latentes mediante la cercanía, la comunicación, el conflicto y la autonomía como dimensiones de la relación. El análisis de perfiles latentes generó una solución de cuatro perfiles, que se catalogaron como seguro, evasivo, ansioso y distante. Posteriormente, se analizaron los resultados de los adolescentes y los padres. Los resultados indicaron que los adolescentes del perfil distante demostraron el mayor nivel de delincuencia, mientras que los padres presentaron el menor nivel de depresión. Los adolescentes del perfil evasivo también demostraron niveles altos de delincuencia, y los padres de este perfil también presentaron el mayor nivel de síntomas de depresión. No se encontraron diferencias de perfiles para los síntomas de depresión en los adolescentes. Se debaten las implicancias para las intervenciones familiares.

Adolescent Gender and Age Differences in Responsiveness to Functional Family Therapy.

The current study contributes to a sparse literature on moderators of Functional Family Therapy (FFT) by examining whether responsiveness to FFT, measured by a broad range of outcomes, varies by adolescent gender, age, and their interaction. This study was informed by 687 families (n, adolescents = 581; n, caregivers = 933) and utilized a pre-post comparison design. Fixed-effects regressions with gender, age, and their interaction included as explanatory variables were conducted to calculate the average change in youth mental health, callous-unemotional traits, academic outcomes, substance use, and family functioning. Moderation analyses revealed that according to parent report, girls had significantly greater improvements in peer problems and family functioning, and boys benefited more in increased liking of school. There were differential effects by age, such that older youth had less beneficial mental health outcomes and a smaller decrease in frequency of hash use. The gender by age interaction was significant for adolescents' report of mental health and family functioning outcomes, which suggests that girls benefit from FFT less than boys during early adolescence, but benefit more than boys in late adolescence. This finding adds to literature which has evidenced that family functioning is particularly important for girls by suggesting that FFT is important for improving older girls' mental health and family functioning in particular. The study's results expand the examination of outcomes of FFT to include academic outcomes, and provide insight into key factors that should be considered in addressing adolescent behavioral problems and family functioning.

El presente estudio contribuye a una bibliografía escasa sobre los moderadores de la terapia familiar funcional (TFF) analizando si la capacidad de respuesta a la TFF, medida por una amplia gama de parámetros, varía según el género, la edad y la interacción de los adolescentes. Este estudio se valió de 687 familias (n, adolescentes=581; n, cuidadores= 933) y utilizó un diseño de comparación previa y posterior. Se llevaron a cabo regresiones de efecto fijo con el género, la edad y su interacción incluidos como variables explicativas a fin de calcular el cambio promedio en la salud mental, los rasgos de insensibilidad emocional, los resultados académicos, el consumo de sustancias y el funcionamiento familiar de los jóvenes. Los análisis de moderación revelaron que de acuerdo con el informe de los padres, las niñas tuvieron mejoras considerablemente mayores en los problemas con los pares y el funcionamiento familiar, y los niños se beneficiaron más en el mayor agrado de la escuela. Hubo efectos diferenciales según la edad, de modo que los jóvenes de más edad tuvieron menos resultados beneficiosos en la salud mental y una disminución más pequeña en la frecuencia del consumo de hachís. La interacción del género según la edad fue significativa para los resultados del informe de salud mental y funcionamiento familiar de los adolescentes, que sugiere que las niñas se benefician de la TFF menos que los niños durante la adolescencia temprana, pero se benefician más que los niños en la adolescencia tardía. Este hallazgo aporta a la bibliografía que indica que el funcionamiento familiar es particularmente importante para las niñas, sugiriendo que la TFF es importante para mejorar la salud mental y el funcionamiento familiar de las niñas de más edad en particular. Los resultados del estudio amplían el análisis de los resultados de la TFF para incluir los resultados académicos, y permiten conocer mejor los factores clave que deben tenerse en cuenta a la hora de abordar los problemas conductuales y el funcionamiento familiar de los adolescentes.

Home Environment and Self-Efficacy Beliefs among Native American, African American, and Latino Adolescents.

Context helps determine what individuals experience in the settings they inhabit. Context also helps determine the likelihood that those experiences will promote adaptive development. Theory suggests likely interplay between various aspects of home context and development of ideas about self that influence patterns of development for children. This study addressed relations between two aspects of home life (companionship and investment, modeling and encouragement) and three types of self-efficacy beliefs (enlisting social resources, independent learning, self-regulatory behavior) considered important for long-term adaptive functioning. The study focused on three groups of minority adolescents (Native American, African American, Latino). Relations were examined using regression models that also included four aspects of household risk that often hinder the development of self-efficacy. Although findings varied somewhat across the three groups, significant relations emerged between the two domains of home life examined and self-efficacy beliefs in all three groups, even controlling for overall household risk. Companionship and investment appeared particularly relevant for African American adolescents, while modeling and encouragement appeared particularly relevant for Native American adolescents. Both were relevant for Latino adolescents.

El contexto ayuda a determinar lo que las personas viven en los entornos que habitan. El contexto también ayuda a determinar la probabilidad de que esas experiencias promuevan el desarrollo adaptativo. La teoría sugiere una probable interacción entre varios aspectos del contexto hogareño y el desarrollo de ideas acerca del yo que influyen en los patrones de desarrollo de los niños. Este estudio abordó las relaciones entre dos aspectos de la vida hogareña (compañerismo e inversión, modelado y fomento) y tres tipos de creencias de autoeficacia (designación de recursos sociales, aprendizaje independiente, comportamiento autorregulado) consideradas importantes para el funcionamiento adaptativo a largo plazo. El estudio se centró en tres grupos de adolescentes de grupos minoritarios (nativo americanos, afroamericanos, latinos). Se analizaron las relaciones usando modelos de regresión que también incluyeron cuatro aspectos de riesgo doméstico que generalmente obstaculizan el desarrollo de la autoeficacia. Aunque los resultados variaron un poco en los tres grupos, surgieron relaciones significativas entre los dos ámbitos de la vida hogareña analizados y las creencias de autoeficacia en los tres grupos, aún teniendo en cuenta el riesgo doméstico general. El compañerismo y la inversión parecieron particularmente relevantes en los adolescentes afroamericanos, mientras que el modelado y el fomento parecieron particularmenete relevantes en los adolescentes nativo americanos. Ambos fueron relevantes en los adolescentes latinos.

Teenage Childbearing, Reproductive Justice, and Infant Mental Health.

Reproductive justice advocates emphasize the rights of women to choose to have children, to decide the conditions under which they give birth, and to parent their children with support, safety, and dignity. This article examines what a reproductive justice perspective contributes to infant mental health work with teenage mothers and their families. It explores the historical framing of teenage pregnancy in which young mothers are the cause of a variety of social problems and in which the primary policy and practice approach is pregnancy prevention. The article offers alternative framings of teenage childbearing, based on reproductive justice principles, which focus on social conditions surrounding teenage parenthood and the meaning of motherhood in the lives of young women. These alternative frames shift the practice agenda to eradicating unjust social conditions and providing supports for young women in their roles as parents. The article then describes ways in which two infant mental health programs have incorporated reproductive justice principles into their work with young families: Chicago's community doula model and Florida's Young Parents Project for court-involved teenage parents. Finally, the article extracts a set of principles deriving from a reproductive justice perspective that are relevant to infant mental health work with young families.

Los defensores de la justicia reproductiva enfatizan los derechos de la mujer de escoger tener niños, decidir las condiciones bajo las cuales dan a luz, y criar sus niños con apoyo, seguridad y dignidad. Este ensayo examina lo que una perspectiva de justicia reproductiva contribuye al trabajo de salud mental infantil con madres adolescentes y sus familias. El ensayo explora el marco histórico del embarazo adolescente en el que las jóvenes mamás son la causa de una variedad de problemas sociales y para el que el principal acercamiento de la política y práctica es la prevención del embarazo. El estudio ofrece alternativas para enmarcar la maternidad adolescente, con base en los principios de la justicia reproductiva, la cual se enfoca en las condiciones sociales que rodean la maternidad adolescente y el significado de maternidad en la vida de las mujeres jóvenes. Estos marcos alternativos cambian la agenda práctica a erradicar las condiciones sociales injustas y proveer apoyo a las mujeres jóvenes en su papel de madres. El estudio describe a continuación maneras por medio de las cuales dos programas de salud mental infantil han incorporado principios de justicia reproductiva en su trabajo con familias jóvenes: el modelo comunitario de Chicago de mujeres que acompañan y ayudan durante el embarazo (Doulas) y el Proyecto de Madres Jóvenes de Florida para progenitores adolescentes involucrados en asuntos legales. Finalmente, el ensayo extrae una serie de principios que se derivan de una perspectiva de justicia reproductiva que son relevantes para el trabajo de salud mental infantil con familias jóvenes.

Les avocats de la justice reproductive mettent l'accent sur les droits des femmes à choisir d'avoir des enfants, à décider des conditions dans lesquelles elles vont donner naissance, et à parenter leurs enfants avec soutien, sécurité et dignité. Cet article examine qu'une perspective de justice reproductive contribue au travail de santé mentale du nourrisson avec des mères adolescentes et leurs familles. Nous explorons le contexte historique de la grossesse adolescente qui veut que les jeunes mères soient la cause d'une variété de problèmes sociaux et au sein duquel la politique primaire et la pratique d'approche consistent en prévention de grossesse. Cet article offre des contextes ou des encadrements alternatifs de la grossesse adolescente, basée sur les principes de justice reproductive, mettant l'accent sur les conditions sociales qui entourent le parentage adolescent et la signification de la maternité dans les vies des jeunes femmes. Ces perspectives alternatives déplacent le but de la pratique vers l'éradication de conditions sociales injustes et l'offre de soutien à ces jeunes femmes dans leurs rôles de parents. Nous décrivons ensuite des manières dont deux programmes de santé mentale du nourrisson ont incorporé des principes de justice reproductive dans leur travail avec des jeunes familles: le modèle de doula communautaire de la ville de Chicago aux Etats-Unis et le Projet de Jeunes Parents pour les parents se trouvant dans un tribunal, programme de l'état de Floride aux Etats-Unis. Enfin, nous présentons un ensemble de principles dérivés d'une perspective de justice reproductive qui sont pertinent pour le travail de santé mentale du nourrisson avec les jeunes familles.

[Effectiveness of educational interventions for the prevention of pregnancy in adolescents]. / Efectividad de las intervenciones educativas para la prevención del embarazo en la adolescencia.

OBJECTIVE: To assess the effectiveness of the interventions to prevent a pregnancy in adolescence. DESIGN: Systematic review. DATA SOURCES: The following databases were consulted: PubMed, CINAHL, Scopus, Cuiden Plus, LILACS, and IME, in order to identify interventions aimed at preventing a pregnancy in adolescence. STUDY SELECTION: A total of 24 primary investigations, in which an educational program to prevent a pregnancy in the adolescence was evaluated, were selected. The quality of the selected studies was assessed according to the CASPe scale. RESULTS: Educational programs for the modification of the teenage pregnancy rate show inconclusive results, as there are 2 studies that find a reduction, and 2 that find that there are no significant changes. For secondary outcomes, it was found that educational programs are effective for increasing the knowledge level about sexuality and contraceptive methods and changing attitudes about the risk of a teenage pregnancy or the use of contraceptive methods. There are no statistically significant differences between the studies with a positive and negative outcome (P>.05) for any of the results analysed in this review. CONCLUSION: There is no a single intervention modality that is the most effective for prevention of a teenage pregnancy. More research is needed with a longitudinal approach that assess not only intermediate results, but also a modification in the pregnancy rate.

Parental Perceived Control and Social Support: Linkages to Change in Parenting Behaviors During Early Adolescence.

Prior studies have found that parents' perceptions of control over their lives and their social support may both be important for parenting behaviors. Yet, few studies have examined their unique and interacting influence on parenting behaviors during early adolescence. This longitudinal study of rural parents in two-parent families (N = 636) investigated (a) whether perceived control and social support when their youth were in sixth grade were independently or interactively associated with changes in parenting behaviors (discipline, standard setting) and parent-child warmth and hostility 6 months later and (b) if these linkages differed by parent gender. We also investigated the interactive links between perceived control, social support, and parenting. Specifically, we tested if parents' perceived control moderated the linkages between social support and parenting and if these linkages differed by parent gender. Greater perceived control predicted more increases in parents' consistent discipline and standard setting, whereas greater social support predicted increases in parent-child warmth and decreases in parent-child hostility. Parental perceived control moderated the effect of social support on parental warmth: For mothers only, social support was significantly linked to parent-child warmth only when mothers had low (but not high) perceived self-control. The discussion focuses on reasons why perceived control and social support may have associations with different aspects of parenting and why these might differ for mothers and fathers.

Parent-Child Attunement Moderates the Prospective Link between Parental Overcontrol and Adolescent Adjustment.

Parental overcontrol (OC), behavior that intrusively or dominantly restricts child autonomy, has been identified as a transdiagnostic risk factor for youth. However, it is as yet unknown whether the association between parental OC and child maladjustment remains even when OC is exerted infrequently or by attuned parents. Rather, the selective use of OC might steer children away from danger. Taking a developmental psychopathology approach, this study focuses on the larger parent-child relationship context, testing whether either the dose at which parents demonstrate OC or the degree to which children perceive their parents as attuned determines whether OC is risky or protective for adolescents' adjustment. Among a community sample of 114 families of children followed from the ages of 12-18, we examine whether OC, behaviorally coded from triadic mother-father-child discussions in middle childhood, is associated with later risky behavior and anxiety symptoms in adolescence. Overcontrol exerted by either mothers or fathers had a curvilinear effect on adolescent risky behaviors, and this effect was moderated by children's perceived attunement. Although OC generally was associated with increased risky behaviors, low doses of OC or OC exerted by highly attuned parents protected against engagement in risky behaviors. No main effect of OC was observed on adolescent anxiety; however, mothers' OC interacted with perceived parental attunement, such that OC exerted by less attuned parents predicted greater anxiety. Results underscore that the effect of parenting behaviors depends on the larger parent-child relationship context.

Family Profiles of Cohesion and Parenting Practices and Latino Youth Adjustment.

Using a sample of 279 (52% female) Latino youth in 9th grade (M = 14.57, SD = .56), we examined profiles of family cohesion and parenting practices and their relation to youth adjustment. The results of latent profile analyses revealed four family profiles: Engaged, Supportive, Intrusive, and Disengaged. Latino youth in the Supportive family profile showed most positive adjustment (highest self-esteem and lowest depressive symptoms), followed by youth in the Engaged family profile. Youth in the Intrusive and Disengaged profiles showed the lowest levels of positive adjustment. The findings contribute to the current literature on family dynamics, family profiles, and youth psychological adjustment within specific ethnic groups.

Longitudinal Course and Correlates of Parents' Differential Treatment of Siblings in Mexican-Origin Families.

Parents' differential treatment (PDT) is a common family dynamic that has been linked to youth development and well-being, including adjustment problems and poor sibling relationships. Much less is known, however, about the developmental course of PDT and the conditions under which parents treat their children differently in adolescence and young adulthood. This study examined longitudinal changes in mothers' and fathers' differential warmth and conflict with their two offspring from early adolescence through young adulthood and examined parents' experiences of individual stress (depressive symptoms and role overload) and marital difficulties as time-varying correlates of (changes in) PDT. We also tested crossover effects to determine whether mothers' experiences of individual stress and marital difficulties were linked to fathers' differential treatment, and vice versa. Participants were mothers, fathers, and two siblings from 246 Mexican-origin families who were interviewed in their homes on three occasions over 8 years. Multilevel models revealed that mothers' and fathers' differential conflict with their two children increased until middle adolescence and then declined into young adulthood, but there were no changes over time for parents' differential warmth. In general, both mothers' and fathers' levels of differential treatment were exacerbated by their own experiences of individual stress and marital difficulties and also by the experiences of their spouses. However, in some cases, greater stress than usual was linked to less differential treatment than usual.

[Psychosomatic symptoms as an expression of the deterioration of the health-related quality of life in adolescents]. / Síntomas psicosomáticos como expresión del deterioro de la calidad de vida relacionada con la salud en adolescentes.

AIM: To analyze, in a population of adolescents in school, the relationship between psychosomatic symptoms and the perception of health-related quality of life (HRQoL), differentiating by gender and age group. DESIGN: Transversal study. LOCATION: Five Secondary Schools. PARTICIPANTS: Eight hundred and forty four adolescents between the ages of 15 and 18 in secondary school. MAIN MEASUREMENTS: HRQoL using KIDSCREEN-52 and psychosomatic symptoms with the psychosomatic problems scale (PSP). RESULTS: Girls and adolescents aged 17-18 years presented significantly higher psychosomatic symptoms, both groups also scored worse in all dimensions of HRQoL, although only the dimensions related to physical and mental wellness, mood and stress reached significance. All psychosomatic symptoms were inversely associated with the ten dimensions of KIDSCREEN-52. The regression models showed that sadness, concentrating difficulties and sleeping difficulties were the predictors of worse HRQoL in both sexes and age groups and these variables explained between 30 and 41% of the HRQoL variance of the adolescents. CONCLUSIONS: Psychosomatic symptoms are frequent especially in girls and in older adolescents and predictors of worse HRQoL. It is important to distinguish them from medical conditions to avoid unnecessary interventions. As expressions of emotional discomfort they must be evaluated and treated in an integral way because they interfere with daily life and increase the vulnerability proper of adolescence.

A Multi-Family Group Intervention for Adolescent Depression: The BEST MOOD Program.

Depression is the most common mental disorder for young people, and it is associated with educational underachievement, self-harm, and suicidality. Current psychological therapies for adolescent depression are usually focused only on individual-level change and often neglect family or contextual influences. The efficacy of interventions may be enhanced with a broader therapeutic focus on family factors such as communication, conflict, support, and cohesion. This article describes a structured multi-family group approach to the treatment of adolescent depression: Behaviour Exchange Systems Therapy for adolescent depression (BEST MOOD). BEST MOOD is a manualized intervention that is designed to address both individual and family factors in the treatment of adolescent depression. BEST MOOD adopts a family systems approach that also incorporates psychoeducation and elements of attachment theories. The program consists of eight multifamily group therapy sessions delivered over 2 hours per week, where parents attend the first four sessions and young people and siblings join from week 5. The program design is specifically aimed to engage youth who are initially resistant to treatment and to optimize youth and family mental health outcomes. This article presents an overview of the theoretical model, session content, and evaluations to date, and provides a case study to illustrate the approach.

Child Characteristics, Parent Education and Depressive Symptoms, and Marital Conflict Predicting Trajectories of Parenting Behavior from Childhood Through Early Adolescence in Taiwan.

The study examined how child and parent characteristics, and contextual sources of stress, such as marital conflict predict initial status and trajectories of parent involvement, support, and harsh control, over a 4-year period in families in Taiwan (n = 4,754). Based on Belsky's (1984) ecological model of parenting, three domains predicting parenting were tested, child characteristics (age cohort and gender), father and mother characteristics (education and depressive symptoms), and contextual sources of stress (marital conflict). The study followed two cohorts of children; the younger cohort was followed from first to fourth grade and the older cohort from fourth to seventh grade. Initially, fourth graders reported more parental involvement, support, and harsh control than first graders. However, involvement, support, and harsh control decreased across the 4 years for the older cohort as they transitioned to early adolescence. In the first year, girls reported more parental involvement and support and less harsh control than boys. Across the 4 years, involvement and support increased, and harsh control decreased for boys; whereas involvement stayed the same, support slightly decreased, and harsh control slightly increased for girls. Children whose parents were more educated reported more parent involvement, support, and harsh control in the first year. Children whose fathers were chronically depressed and whose parents were experiencing marital conflict reported decreasing parent involvement and support over the years.

Parentification, Stress, and Problem Behavior of Adolescents who have a Parent with Mental Health Problems.

When adolescents live with a parent with mental illness, they often partly take over the parental role. Little is known about the consequences of this so-called parentification on the adolescents' internalizing and externalizing problems. This survey study examined this effect cross-sectionally and longitudinally in a sample of 118 adolescents living with a parent suffering from mental health problems. In addition, the study examined a possible indirect effect via perceived stress. Path analyses were used to examine the direct associations between parentification and problem behavior as well as the indirect relations via perceived stress. The results showed that parentification was associated with both internalizing and externalizing problems cross-sectionally, but it predicted only internalizing problems 1 year later. An indirect effect of parentification on adolescent internalizing and externalizing problems via perceived stress was found, albeit only cross-sectionally. These findings imply that parentification can be stressful for adolescents who live with a parent with mental health problems, and that a greater awareness of parentification is needed to prevent adolescents from developing internalizing problems.