BACKGROUND:: It is advised that children up to two years of age avoid any screen time (i.e., using digital screens), that those between the ages of two and five years should not exceed one hour per day, and that children aged five to 12 years should only have access to two hours of screen time per day. However, in the digital age, parents find it difficult to control the time their children spend on screens. AIM:: This article aimed to systematically synthesise the evidence on the associations between screen time and mental health outcomes in children aged 0 to 12 years. METHOD:: A systematic literature review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search was defined according to the Population, Exposure, Comparator, and Outcomes (PECO) strategy, using the descriptors 'children', 'screen time' and 'mental health' when searching the databases PubMed, Scopus, and PsycINFO. Articles were included if they directly evaluated the associations between screen time and mental health, measured the results using validated instruments, included children aged 0 to 12 years, and were published since 2013. The Newcastle-Ottawa scale was used to check the methodological quality of the studies. The results were described by presenting the characteristics of the studies, the quality assessment, and the associations between screen time and mental health in longitudinal and cross-sectional studies. RESULTS:: This review assessed the quality of evidence and the frequency with which different mental health problems have been investigated in relation to screen time in children. Fifty-two studies were included, with most addressing attention deficit-hyperactivity disorder (n = 19), conduct problems (n = 13), externalising symptoms (n = 9), depression (n = 11), and anxiety (n = 9). Symptoms of attention deficit-hyperactivity disorder, oppositional defiant disorder, mood symptoms, emotional and social difficulties, conduct problems, low self-esteem, and sleep disturbances were positively associated with screen time, presenting evidence considered to be of high quality. LIMITATIONS:: Although this review concluded that screen time significantly affects children's mental health, some limitations should be noted. The lack of longitudinal data made it difficult to establish a clear causal relationship in most studies, and screen time measures may have introduced a potentia memory bias, as well as relying on parental recall. CONCLUSION:: Screen time warrants careful consideration in relation to children's mental health. Promoting off-screen activities may be crucial to reducing the risk of unfavourable mental health outcomes associated with exposure to the digital environment. Future research should focus on longitudinal studies to understand the causal relationships between children's psychosocial responses to the different purposes of screen use and the type of content to which they are exposed.
BACKGROUND:Sexual minority youth (SMY) experience disproportionately high rates of suicide. Previous research has identified a relationship between sexual violence and suicidal behaviours within this population. While emerging evidence suggests a possible association between sexual violence and risky sexual behaviours (RSB), the impact of RSB on suicide among SMY remains unclear. OBJECTIVE:The current study examined the relationship between sexual violence, RSB, and suicide attempts among SMY using data from the national Youth Risk Behavior Survey (YRBS). METHODS:High school students (n = 456; grades 9 to 12) in the United States of America who identified as gay, lesbian, or bisexual answered questions about past-year sexual assault, engagement in RSB, and past-year suicide attempts. RESULTS:Hierarchical binomial logistic regression analyses indicated that past-year sexual assault was significantly associated with past-year suicide attempts, such that SMY who experienced sexual violence in the past year were at a greater risk of making a suicide attempt within this same period. Bisexual youth were also at a higher risk of recent suicidal behaviour relative to their gay and lesbian peers. However, RSB variables were not significantly associated with suicide attempts within the model. CONCLUSION:Findings underscore the critical association between sexual violence and suicide risk among SMY. Implications for future research and targeted, inclusive prevention efforts are discussed.
BACKGROUND:Although the COVID-19 pandemic's negative impact on mental health has been well established, more research is needed to better understand the vulnerability of certain populations. AIM:This study compared the perceived negative impact of COVID-19 on mental health between United States of America (USA) adolescents with and without a past-year major depressive episode (MDE). Additionally, we examined factors associated with higher perceived negative impact among those with a past-year MDE. METHOD:The sample included adolescents aged 12 to 17 years from the 2021-2023 National Surveon Drug Use and Health (N = 31 861). Based on self-reported past-year MDE, participants were grouped as either with (n = 6 186) or without past-year MDE (n = 25 675). The prevalence of the perceived negative impact of COVID-19 on mental health was assessed between groups. Adjusted logistic regression was then conducted to examine factors associated with higher perceived negative impact among adolescents with past-year MDE. RESULTS:USA adolescents with past-year MDE were significantly more likely to report higher perceived negative impact than those without an MDE (41% vs. 10.3%). Among adolescents with past-year MDE, females, older adolescents, and individuals from higher household income levels were more likely to report higher perceived negative impact than their respective counterparts. Additionally, financial worries due to COVID-19 were a significant predictor, showing a positive association with higher perceived negative impact. DISCUSSION:It is crucial to implement targeted interventions for high-risk subgroups of adolescents with a mental health condition to address their unique needs and mitigate the pandemic's lasting effects on mental health.
Background: Exposure of children and young people to potentially traumatic events is common. There is a need for increased access to early interventions following a potentially traumatic event.Objective: This review aimed to identify early psychotherapeutic interventions which attempted to decrease posttraumatic stress responses and/or reduce the risk of developing persistent posttraumatic stress disorder.Method: We included papers that outlined a psychotherapeutic intervention delivered to children and young people in the acute (within 1 month) and early-post-trauma period (2 to 6 months), following a potentially traumatic event. Four databases were searched, including PubMed, PsycINFO, Web of Science, and ASSIA.Results: Twenty-one papers met the inclusion criteria. The most frequent technique identified was psychoeducation, often combined with other techniques. Interventions were typically delivered by highly experienced clinical professionals. Two interventions were delivered either by lay counsellors or community facilitators. Most interventions were delivered within 1 month of exposure.Discussion: All interventions delivered beyond 1 month after the event showed significant reductions in posttraumatic stress symptoms, whereas those delivered within a month yielded mixed results. Conclusions: There remains a scarcity of evidence on early interventions following potentially traumatic events. We identified interventions delivered by community professionals with less clinical experience, which could inform how we increase access to support following potentially traumatic events.
BACKGROUND:Globally, child and adolescent mental health services are a priority. Efforts are being made to highlight the gap in health systems concerning the lack of these services and to provide evidence for their necessity, particularly in disadvantaged areas such as rural communities in low- and middle- income countries. OBJECTIVE:This study aimed to investigate the perceptions of child and adolescent mental health services within primary healthcare facilities and secondary schools in rural communities of the Chris Hani District in the Eastern Cape province, South Africa. METHOD:The study employed a qualitative research approach with an exploratory design, recruiting 36 participants, including 12 professional nurses and 24 secondary school teachers, through purposive sampling. Data were collected via individual semi-structured interviews (n = 12) with professional nurses and focus group discussions (n = 6) with teachers. Data were analysed using thematic analysis. RESULTS:The findings demonstrated a lack of child and adolescent mental health services in both primary healthcare facilities and secondary schools in rural communities, where children and adolescents could potentially access such services. Specifically, primary healthcare facilities reported having no mental health patients under the age of 18 years. Both healthcare professionals and schoolteachers indicated a lack of expertise in implementing services. CONCLUSION:Child and adolescent mental health services are lacking in rural communities of the Chris Hani District, Eastern Cape province, South Africa.
BACKGROUND:Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder diagnosed in childhood. Untreated ADHD can impair development and increase the likelihood of psychopathology due to executive dysfunctions. AIM:This review examined the effect of attention training on executive functions in children with ADHD. METHODS:A literature search was conducted in Scopus, PubMed, CINAHL, Cochrane, and Embase databases from January 2004 to May 2024, following PRISMA guidelines. Randomised clinical trials (RCTs) involving children with ADHD (younger than 17 years) that included attention training alone or alongside standard treatments (such as medication) with executive functions as primary outcomes were included. Review Manager (RevMan), Version 5.4.1 and the Cochrane Collaboration, 2011, was used to evaluate study quality. The random effects model was used, and heterogeneity was measured via the I2 statistic. RESULTS:Five studies (N = 289) were included in the systematic review and three in the meta-analysis. The analysis revealed a significant effect of attention training on the global executive composite (SMD = 1.17, 95% CI:-2.11 to -0.23, p = 0.010), the behavioural regulation index (SMD = -0.34, 95% CI: -0.68 to -0.01, p = 0.040), and the metacognitive index (SMD = -0.70, 95% CI:-1.11 to -0.29, p < 0.001). Thus, attention training can enhance the behavioural and metacognitive functions of children with ADHD. CONCLUSION:This review revealed that attention training may improve executive functions in children with ADHD. However, due to a few studies and heterogeneity, the findings must be interpreted cautiously.
Background: Loneliness poses various risks for adolescents, but the role of perceived social support in mitigating loneliness requires further exploration. This study examined the loneliness trajectories among early adolescents during the COVID-19 pandemic and explored the impact of different types of perceived social support.Methods: A three-wave survey of 635 adolescents measured perceived social support and loneliness. Latent growth mixture model and logistic regression identified heterogeneous loneliness trajectories and the effects of perceived support.Results: Three loneliness trajectories were identified, including a high-increasing trajectory (14.02%), a moderate-increasing trajectory (21.73%), and a low-decreasing trajectory (64.25%). Early adolescents with lower emotional support were more likely to belong to the medium-level stable group than the low-level declining group, while enhancement of worth predicted medium-level stable membership. Increased intimacy was associated with a high-level rising trajectory.Conclusion: The findings underscore unique loneliness trajectories and the essential role of perceived social support, guiding targeted psychological interventions.
BACKGROUND:Non-suicidal self-injury (NSSI), the intentional and direct harm to one's own body without suicidal intent, has emerged as a significant public health concern among adolescents. Despite its high prevalence and strong association with mental health disorders, demographic and psychosocial predictors remain underexplored, particularly in diverse populations in the United States of America. METHODS:The investigators analysed cross-sectional data from the 2020 Parents' Resource Institute for Drug Education (PRIDE) survey, encompassing 35 695 adolescents aged 12 to 17 years from 133 schools in the greater Cincinnati, Ohio area. Multivariate logistic regression models were employed to examine associations between past-30-day NSSI and mental health factors (depression, anxiety), psychosocial stressors (bullying, stress), and demographic variables (age, sex, race/ethnicity). RESULTS:Approximately 6.2% of youth reported past-month NSSI. Female adolescents (aOR: 1.45), Hispanic (aOR: 1.37) and multi-racial youth (aOR: 1.30) were at elevated risk for NSSI. Younger adolescents (12 to 13 years) had higher odds of NSSI compared to older peers. Depression (aOR: 14.2), anxiety (aOR: 1.99), bullying (aOR: 3.93), and stress (aOR: 1.70) were all significantly associated with increased NSSI risk. CONCLUSIONS:In this study, NSSI affected over 1 in 20 adolescents and was strongly linked to mental health distress and social adversity. Our findings highlight the need for early, targeted, and culturally sensitive interventions that address both individual psychological vulnerability and broader psychosocial stressors in youth populations.
BACKGROUND:The relationship between separation anxiety disorder (SAD) and behavioural inhibition remains unclear. Additionally, aggression and emotional expression in SAD have not yet been systematically studied. This study aimed to investigate behavioural inhibition, aggression, and emotional expression in children with SAD. METHODS:The study included 30 treatment-naive patients with SAD (46.7% girls) and 30 healthy controls (HC) (33.3% girls), aged 60 to 84 months (70.76±9.44 months). The parents completed the Separation Anxiety Assessment Scale-Parent Version (SAAS-P), the Child Emotion Expressiveness Questionnaire (CEEQ), the Behavioural Inhibition Questionnaire (BIQ), and the Children's Aggression Scale-Parent Version (CAS-P). RESULTS:Total and subscale scores of the SAAS-P and BIQ were significantly higher in patients with SAD. Conversely, the SAD and HC groups' CEEQ and CAS-P subscale scores did not differ significantly. Binary logistic regression analysis was conducted to examine whether behavioural inhibition predicts SAD status. The BIQ score significantly and positively predicted SAD status (OR = 1.09, 95% CI: 1.04-1.14, p < 0.001). CONCLUSIONS:Behavioural inhibition was significantly associated with SAD. Early recognition and intervention for behavioural inhibition can alter the development and course of the disorder.
Background: Healthcare providers in Ethiopia require validated tools to screen paediatric patients for suicide risk in Amharic, the official language of Ethiopia. Objective: This study aimed to examine the psychometric properties of the Ask Suicide-Screening Questions (ASQ) tool in Amharic among Ethiopian paediatric patients. Method: This cross-sectional instrument validation study was conducted from February 2021 to September 2022. Paediatric patients were recruited from the emergency department, outpatient clinics, and medical inpatient units at Tikur Anbessa Specialised Hospital in Addis Ababa, Ethiopia. Paediatric patients (aged 10 to 18 years, inclusive) were enrolled. Participants completed the Amharic language version of the ASQ, the index test. A brief suicide safety assessment administered by a clinician served as the reference standard for validation. Results: A total of 159 paediatric patients were enrolled; 42 youth (26%) screened positive on the ASQ, and 10 (6%) were deemed "at risk" for suicide by a clinician. Compared to the reference standard, the ASQ had a sensitivity of 1.000 (95% confidence interval [CI]: 1.000 to 1.000), specificity of 0.785 (95% CI: 0.719 to 0.851), and area under the curve value of 0.890 (95% CI: 0.860 to 0.926). While most youth (n = 117; 74%) felt comfortable being screened for suicide risk, only 52.2% (n = 83) thought medical providers should ask youth about suicide. Conclusions: The Amharic version of the ASQ demonstrated strong psychometric properties and appears to be a valid suicide risk screening tool in the sample population. Future research should explore the feasibility and acceptability of screening Ethiopian paediatric patients for suicide risk.
BACKGROUND:Children and adolescents living in conflict-driven humanitarian contexts face heightened risks of violence and abuse, which can significantly affect their immediate and long-term well-being. The evaluation of interventions to support adolescent well-being in these settings requires a validated, simple, yet robust measure of the broad construct of psychological well-being. OBJECTIVE:This study aimed to validate the WHO-5 Well-being Index, a short, self-reported instrument designed to assess subjective psychological well-being, for use with adolescents in two conflict- affected humanitarian contexts, including Colombia and Nigeria. METHOD:Participants (N = 172) were aged 13 to 17 years and resided in Colombia (n = 90) or Nigeria (n = 82). Exploratory and confirmatory factor analyses were conducted to assess the WHO-5 Index psychometric properties. RESULTS:A one-factor structure of the WHO-5 Well-being Index was supported, showing high internal consistency (α and ω > 0.80), excellent convergent validity (assessed with the Kidscreen-27 scale, r = 0.797, p < 0.01), and acceptable discriminant validity (assessed with the PHQ-9 scale, r = -0.343, p < 0.001). Confirmatory factor analysis supported the one-factor model, initially with poor fit (CFI = 0.972, TLI = 0.944, RMSEA = 0.105). After accounting for covariance between items 3 and 4, the model fit improved significantly (CFI = 0.998, TLI = 0.994, RMSEA = 0.034). CONCLUSION:This study reaffirms the WHO-5 Well-being Index as a valid instrument to assess the well-being of Spanish- and Hausa-speaking adolescents who have experienced family separation, abuse, violence, neglect, and/or exploitation in humanitarian contexts.
BACKGROUND:Eating disorders (EDs) are serious and prevalent diagnoses during adolescence. Therefore, prevention efforts are strongly recommended. However, there is a gap in the literature regarding a comprehensive understanding of preventive strategies for EDs in adolescents, particularly concerning different contexts and methodological approaches. OBJECTIVE:This study aimed to map and describe preventive interventions, considering various contexts, modalities, and components. METHOD:A scoping review was conducted following the JBI and PRISMA-ScR guidelines. Primary studies on psychosocial interventions for ED prevention in non-clinical adolescent samples, published between 2013 and 2025 in Portuguese, English, or Spanish, were included. Searches were conducted in PubMed, Scopus, Web of Science, PsycINFO, LILACS, and CINAHL. Publications underwent screening, selection, and data extraction followed by synthesis. RESULTS:Twenty-one studies were included, most with exploratory designs. The interventions were predominantly group-based, in-person, and grounded in cognitive dissonance theory, with a mean participant age of 14.39 years (SD = 1.42 years). The main strategies were psychoeducation, group discussion, and practical activities. The main topics were critiques of appearance ideals, media literacy, body image, self-esteem, physical activity, and healthy nutrition. CONCLUSION:Preventive psychosocial interventions for EDs among adolescents are expanding, with a trend towards adapting evidence-based programmes to diverse contexts, countries, cultures, age groups, and specific populations.
BACKGROUND:The COVID-19 pandemic profoundly disrupted education in South Africa, yet quantitative investigations into its mental health impact among learners in late adolescence remain scarce. This study examined associations between COVID-19-related cognitive appraisals and psychological outcomes among late-adolescent learners (aged 18-19 years), a group navigating the transition to adulthood amid substantial educational and social uncertainty. METHOD:A convenience sample of 239 late-adolescent learners (mean age = 18.13 years; 72% female) from seven public schools in informal and semi-urban communities in the Western Cape completed an online survey between March and August 2022. Standardised measures assessed symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), alcohol use, fear of COVID-19, perceived vulnerability to disease, and COVID-19-related worry. RESULTS:High levels of psychological distress were observed within the sample: 59% reported clinically significant depressive symptoms, 39% severe anxiety, 35% clinically significant PTSD symptoms, and 13% alcohol use suggestive of dependence. Hierarchical regression analyses indicated that fear of COVID-19 was a significant predictor of all four mental health outcomes (p < 0.001). Perceived vulnerability to disease independently predicted PTSD symptoms (p < 0.001) and alcohol use (p < 0.01). Conclusion: These findings highlight the importance of school-based mental health interventions that target learners' cognitive appraisals of threat and vulnerability during periods of educational disruption, with implications for strengthening preparedness for future public health emergencies.
Background: Non-suicidal self-injury (NSSI) is common among adolescents and is often associated with suicidal behaviour. NSSI generally functions as a dysfunctional emotion regulation strategy maintained by shame and self-criticism. Compassion-Focused Therapy (CFT) aims to modify these processes through developing self-compassion.Objective: This pilot study evaluated the feasibility and preliminary effectiveness of CFT in reducing NSSI behaviours, shame, and self-criticism in adolescent girls engaging in NSSI.Methods: In this pilot quasi-experimental study, 30 self-harming adolescent girls (mean = 16.76 years; SD = 1.38 years; range = 16 to 19 years) from Tabriz, Iran (2024), were recruited via convenience sampling and randomly allocated to an experimental group (n = 15) receiving eight weekly 70-minute CFT sessions based on Gilbert's protocol, or a no-intervention control group (n = 15). The State Shame and Guilt Scale-shame subscale, the Levels of Self-Criticism Scale-internalised subscale, and the Deliberate Self-Harm Inventory were administered at pre-test and one-week post-intervention. Data were analysed using MANCOVA and follow-up univariate ANCOVAs (controlling for baseline scores) with Bonferroni correction.Results: Compared to the control group, the CFT group showed significant and large reductions at post-test in NSSI severity (adjusted mean diff: -3.20, F(1,27) = 76.75, p < 0.001, η2 = 0.74), shame (adjusted mean diff: -3.59, F(1,27) = 35.50, p < 0.001, η2 = 0.57), and self-criticism (adjusted mean diff:-16.53, F(1,27) = 215.59, p < 0.001, η2 = 0.89). The control group showed no significant changes.Conclusion:This study provides preliminary evidence supporting the feasibility and potential effectiveness of CFT in concurrently reducing NSSI behaviours, shame, and self-criticism among adolescent girls. Findings support CFT's potential as a targeted intervention addressing core mechanisms underlying NSSI in this vulnerable population, warranting further investigation with larger samples and longer follow-ups.
Fear of Missing Out (FoMO) is a widespread apprehension that arises when people believe that others are engaging in enjoyable activities without their presence. The FoMO scale has been widely used, but confirmatory factor analysis is needed to validate its structure. This study aims to analyse the psychometric properties of the FoMO scale among Indian adolescents and explore its mental health correlates. The sample consisted of 708 adolescents aged 13 to 19 years. Both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were conducted to evaluate the factor structure of the FoMO scale. Additionally, the study assessed psychological correlates using the Depression, Anxiety, and Stress scale and the Satisfaction with Life Scale. EFA revealed three factors: societal connectivity, social discomfort, and self-perception. CFA confirmed this structure with acceptable goodness-of-fit indices. The scale showed good reliability and validity. Although the correlations with psychological variables were not statistically significant, they do contribute to the contextual understanding of the broader psychological landscape of FoMO. The study confirms the three-factor model of the FoMO scale among Indian adolescents, emphasising cultural differences in the experience and measurement approaches towards FoMO. This research reiterates the need for culturally sensitive adaptations of psychometric tools and provides preliminary insights into the psychological correlates of FoMO. Further, there is a need for interventions that address the social-emotional dimensions of digital engagement among youth.
INTRODUCTION:This study explores the impact of the COVID-19 pandemic on the psychological well-being of adolescents in the province of Pavia. METHODS:We analysed data from a non-clinical sample of 1 779 adolescents, aged 13 to 19 years, to assess internalising and externalising psychological symptoms. Participants completed a comprehensive self-report survey. RESULTS:Our findings reveal significant sex differences, with females showing higher levels of internalising symptoms such as anxiety and depression compared to males. No significant sex differences were found for externalising symptoms. We examined correlations between these psychological symptoms and factors like age, suicidal ideation, and eating problems. CONCLUSION:This study underscores the prevalence of mental health challenges among adolescents in the post-pandemic context and highlights the need for targeted interventions. Our findings may inform efforts to enhance adolescent well-being by addressing both risk and protective factors in collaboration with families and educational communities.
Background: Mental health concerns have been steadily rising worldwide, including in the Philippines. Given the shortage of mental health specialists in the country, it is crucial to make psychosocial support more accessible and available to Filipino youth.Objective: This study evaluated the feasibility of implementing Katatagan Plus, a resilience intervention for youth at risk of mental health issues, in seven local government units across two regions in the Philippines. Specifically, it aimed to measure the effectiveness of the Katatagan Plus program in developing resilience through adaptive coping, socio-emotional skills, and well-being, and reducing the risk of substance use and depressive symptoms.Method: Seventy-one adolescents screened as being at risk for mental health problems were invited to participate in the program. Most (68%) were participants in community-based programs facilitated by municipal health officers, whereas the remaining (32%) participated in school-based programs facilitated by school guidance personnel. Pre- and post-test surveys were conducted to measure program efficacy and changes in mental health outcomes.Results: Significant improvements in adaptive coping and well-being were observed from the pre- and post-tests. The proportion of participants with scores indicating good well-being rose from 49% to 70% before and after the program. There was also a significant decrease in depression symptoms and substance use. No differences were found in terms of setting/service provider for adaptive coping, substance use, and depression. However, improvements in well-being were greater among students in school-based settings compared to community settings.Conclusion: Results suggest the potential of this early mental health intervention for young people at risk, as well as the need for referrals for those who may need more specialised support.
