The Validity of the Residuals Approach to Measuring Resilience to Adverse Childhood Experiences

Background: Resilience is broadly defined as the ability to maintain or regain functioning in the face of adversity. Recent work to harmonise the quantification and definition of resilience quantifies resilience as the residual variance in psychosocial functioning that remains after accounting for adversity exposure. However, there have been no published studies that have formally investigated the validity of this approach. Considering this, we examine the construct and predictive validity of the residuals approach using participants from ALSPAC. Methods: We regressed exposures of adolescent adversity on adolescent psychopathology scores using the Strength and Difficulties Questionnaire and obtained the residual variance. We investigated construct validity by analysing whether previously identified demographic and resilience factors significantly predicted resilience. Predictive validity of resilience was investigated by comparing the predictive power of resilience with other determinants of psychosocial functioning on two developmental outcomes: depressive symptoms at 18 years, measured by the Short Moods and Feelings Questionnaire, and NEET (Not in Employment, Education or Training) status at 17 and 23 years. The associations between depressive symptoms at 18, resilience, ACEs and covariates were tested using multiple linear regression. NEET status at 17 and 23 were run as separate binary multiple logistic regression models to test associations with resilience and known demographics previously associated with NEET status.Results: Seven previously identified protective factors, including self-esteem, positive sibling relationship, temperament, and positive perception of school, significantly predicted resilience to adolescent psychopathology, thus providing strong construct validity. Resilience significantly predicted a reduction in depressive symptoms at 18 years, and significantly decreased the likelihood of having NEET status at both 17 years and 23 years, even after taking into account early childhood adversity and other risk factors. None of the socioeconomic factors were significantly associated with resilience.Conclusions: Our study demonstrates that the residuals method of operationalising resilience has good construct and predictive validity yet recommend replication studies. It has the potential to advance research into the mechanisms and modifiability of resilience.Trial Registration: Not applicable

Parenting behaviors, parenting styles, and non-suicidal self-injury in young people: a systematic review

Non-suicidal self-injury (NSSI) is a worrying phenomenon that is prevalent among young people. Prior theorizing and empirical evidence suggest that parenting may play a role in the etiology of NSSI. Thus, we conducted a systematic review to examine the association between parenting behaviors and parenting styles with NSSI in young people. Methods: The following databases were searched for relevant articles in July 2020: PubMed, EMBASE, CINAHL Plus, and PsycINFO. Studies were included if they sampled young persons aged 10–25 years old with a history of NSSI, assessed parenting behavior or style, and tested associations between parenting and NSSI outcomes. Results: A total of 26 studies were included in this review. Among parenting behaviors, low parental support, high psychological control, and high reactive control were more consistently associated with NSSI. Conversely, the evidence for behavioral control is equivocal. There is some evidence that invalidating parenting is also associated with NSSI. Conclusion: Consistent with the wider adolescent psychopathology literature, parenting that is perceived to be supportive, less psychologically controlling and reactive/punitive were less likely to be associated with NSSI. However, these results were largely based on child reports of parenting. Limitations and directions for future research are discussed.

Beier Sentence Completion Test Profiles of Adolescents and Emerging Adults With Internalizing and Externalizing Disorders

Background: Understanding adolescents' and emerging adults' psychiatric complaints and their relations with psychiatric disorders can be challenging. Beier Sentence Completion Test (BSCT), as a projective test, can be promising in this respect. However, relations between BSCT profiles and adolescent psychopathology are not well known. Aim: This study aimed to examine and compare BSCT profiles of adolescents and emerging adults with internalizing and externalizing disorders. As well as that, the relation of BSCT profiles with depression and anxiety scores was investigated. Objective: To achieve this aim, we retrospectively collected the hospital records of 300 adolescents and emerging adults (aged. 14-21) admitted to an Adolescent Psychiatry Outpatient Unit. Method: The psychiatric diagnosis of the patients was classified as Internalizing (n =100) and Externalizing (n = 100) disorder groups; the control group (n = 100) consisted of adolescents and young adults without any psychiatric diagnosis. BSCT, the Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were administered on the first admission to all cases before psychiatric evaluation and treatment. BSCT total subfactor (positive, negative, neutral, and non-response) statement scores were compared between groups, and their correlations with BDI and BAI were investigated. Besides, multivariate logistic regression analyses were conducted for estimating any diagnostic group differences, as well as bivariate logistic regression analyses for estimating BDI and BAI cutoff scores with models that included BSCT total subfactor statement scores. Results: It was revealed that lower positive and non-response statements were crucial for distinguishing externalizing and internalizing disorders and that positive and negative statements were correlated with depression and anxiety scores.In the multivariate regression model, these correlations were predictive only for the relationship between internalizing disorders group and low positive statement scores, not higher negative statement scores that can be associated with lack of positive emotional processing in this group. Also, nonresponse statement scores were found to be predictive for externalizing disorder groups. Similarly, BDI cut-off scores were predicted with low positive statement scores. Conclusion: BSCT profiles can be promising for understanding adolescents and emerging adults with internalizing and externalizing disorders. Lack of positive attributions to the self and other domains of life can be important for differentiating adolescent psychopathology.

Daily-Life Social Experiences as a Potential Mediator of the Relationship Between Parenting and Psychopathology in Adolescence

Adolescence is a vulnerable period for psychopathology development, and certain parenting styles are consistent and robust predictors of a broad range of mental health outcomes. The mechanisms through which maladaptive parenting styles affect the development of psychopathology are assumed to be largely social in nature. Yet, the social mechanisms linking parenting to psychopathology are unexplored at arguably the most important level of functioning: daily life. This study aims to identify the associations between three parenting styles, and the experience of daily-life social interactions. Furthermore, we aim to explore the extent to which these parenting styles and altered daily-life social experiences are associated with psychopathology. In this study, we recruited a sample of N = 1,913 adolescents (63.3% girls; mean age = 13.7, age range = 11 to 20) as part of the first wave of the longitudinal cohort study “SIGMA”. Parenting styles (psychological control, responsiveness, and autonomy support) and psychopathology symptoms were assessed using a retrospective questionnaire battery. The experienced quality of social interactions in different types of company was assessed using the experience sampling method, ten times per day for 6 days. Direct associations between parenting styles and general quality of daily-life social experiences were tested using a three-level linear model, revealing significant associations between social experiences and different parenting styles. When interaction effects were added to this model, we found that maternal responsiveness and paternal psychological control mainly related to altered qualities of social interactions with parents, while paternal autonomy support was associated with better experiences of non-family social interactions. Finally, an exploratory path analysis highlighted how both paternal autonomy support and altered quality of non-family interactions are uniquely associated with psychopathology levels. These findings demonstrate the general and pervasive effects of maladaptive parenting styles, as parenting seems to broadly affect adolescents' interactions with different types of social partners in everyday life. Moreover, they illustrate a potential mediated relationship in which altered daily-life social interactions could drive the development of psychopathology. A stronger focus may be required on the role of altered day-to-day social experiences in the prevention and potentially, the treatment, of adolescent psychopathology.

Exposure to violence as an environmental pathway linking low socioeconomic status with altered neural processing of threat and adolescent psychopathology

Background: Low childhood socioeconomic status (SES) is associated with increased risk for psychopathology, due in part to heightened exposure to environmental adversity. Adverse experiences can be characterized along dimensions, including threat and deprivation, that contribute to psychopathology via distinct mechanisms. The current study investigated a neural mechanism through which threat and deprivation may contribute to socioeconomic disparities in psychopathology.Methods: Participants were 177 youths (83 female) aged 10-13 years recruited from a cohort followed since age 3. SES was assessed using the income-to-needs ratio at age 3. At age 10-13, restrospective and current exposure to adverse experiences and symptoms of psychopathology were assessed. At this same timepoint, participants also completed a face processing task (passive viewing of fearful and neutral faces) during a functional magnetic resonance imaging scan. Results: Lower childhood SES was associated with greater exposure to threat and deprivation experiences. Both threat and deprivation were associated with higher depression symptoms, whereas threat experiences were uniquely linked to PTSD symptoms. Greater exposure to threat, but not deprivation, was associated with higher activation in dorsomedial prefrontal cortex (dmPFC) and precuneus to fearful compared to neutral faces. Precuneus activation in this contrast mediated the association between SES and PTSD symptoms. Conclusion: Precuneus and dmPFC are hubs of the default mode network thought to be involved in internally directed attention and cognition. Greater engagement of these regions in response to threat cues may contribute to PTSD symptomatology. Threat and contributes to socioeconomic disparities in adolescent psychopathology through distinct neural mechanisms from deprivation.