Amid rapid social changes in China, understanding the patterns and influencing factors of early adolescents’ mental health is critical for capturing the evolving mental health landscape among youth. This longitudinal study aimed to identify heterogeneous dual-factor mental health profiles and examine their transitions and associated factors among early adolescents in southwestern China. Participants were 11- to 15-year-old adolescents recruited from southwestern China and assessed at three time points. Dual-factor mental health was assessed using indicators of depressive symptoms, anxiety symptoms, subjective well-being, and social adaptation. Latent profile analysis and latent transition analysis were conducted to identify mental health profiles and examine their stability and transitions over time. Regression analyses were performed to examine the associations of emotion regulation strategies and perceived social support with profile membership and transitions. Four heterogeneous mental health profiles were identified across assessments: Flourishing, Moderately Mentally Healthy, At-Risk, and Troubled. The At-Risk profile represented a distinct and relatively stable risk state, characterized by elevated psychological distress and relatively less impaired positive functioning than the Troubled profile. The profiles showed different stability and transition patterns, with an overall tendency toward intermediate mental health states over time. Cognitive reappraisal showed protective associations, whereas expressive suppression showed risk associations with mental health profiles and transitions. Among sources of perceived social support, family support demonstrated the most consistent protective associations, whereas perceived support from others showed more complex associations. These findings highlight the heterogeneity and dynamic nature of early adolescents’ mental health and underscore the importance of considering both psychological distress and positive functioning. These findings may inform more targeted prevention and intervention strategies that support adaptive emotion regulation and differentiated social support for adolescents experiencing elevated mental health risks.
Non-suicidal self-injury (NSSI) is a significant mental health issue among adolescents, especially those with histories of sexual trauma. This study examined the individual and synergistic roles of posttraumatic stress symptoms (PTSS), depression, anxiety, and sleep quality in predicting NSSI among Iranian adolescents. We conducted a cross-sectional study with 448 Iranian adolescents (aged 14–18 years; 60.7
What factors contribute to the increased risk for antisocial behavior in youth, and more importantly, what explains why most youth at risk desist when they grow older? In the Growing Up Together in Society (GUTS) research program, we aim to answer these vital questions from a biopsychosocial perspective in a longitudinal cohort study. The GUTS GO cohort study specifically focuses on youth at risk who have difficulties in pursuing personal and societal goals. The main objective of this study is to explore why, even though some youth show early signs of antisocial behavior, most adolescents do not continue to display antisocial behavior. We will examine the social, contextual, biological, and behavioral mechanisms involved in the persistence or desistance of antisocial behavior, with main focus on the role of self-regulation, empathy and trust. We aim to assess the impact on adolescents’ functioning in various societal contexts, including educational settings, social relationships, and adherence to societal norms. In this paper, we describe in detail the design of the GUTS GO study, the study population, the determinants, intermediate neurocognitive measures, and outcomes. Furthermore, we provide a detailed description of the procedures for inclusion, informed consent, recruitment, and our collaboration with network partners. Keywords: Adolescence; Antisocial Behavior; Youth at Risk; Self-regulation; Empathy; Trust; Longitudinal Cohort; Neurocognitive Development
Evidence increasingly supports the mental health benefits of self-compassion, yet longitudinal research on how it links to mental health remains limited. This study aimed to explore how mindsets about negative emotions—beliefs about whether negative emotions can change—might explain the prospective relationship between self-compassion and youth mental health outcomes. A longitudinal survey was conducted annually over three years with 719 secondary school students (mean age: 14.65, SD: 0.72). Mediation models were tested with self-compassion at T1 as the independent variable, negative emotion mindset at T2 as the mediator, and depression, anxiety, and life satisfaction at T3 as the dependent variables. Alternative mediation models, with negative emotion mindset at T1 as the independent variable and self-compassion at T2 as the mediator, were also examined to confirm the hypothesized direction of mediation. All models controlled for age, sex, socioeconomic status, and baseline measurements of the mediator and dependent variables. The negative emotion mindset at T2 robustly mediated the longitudinal associations between self-compassion at T1 and depression, anxiety, and life satisfaction at T3 (95
Adolescents with autism often face significant challenges, which can lead to emotional dysregulation (ED). For some, existing treatments are inadequate. This study examined whether Psychotherapy Incorporating Horses (PIH), using the Pegasus protocol, supports improvements in emotion regulation through goal attainment in adolescents with autism and persistent ED. This study included 36 adolescents (aged 11–18) with autism and persistent ED. Participants received 15 weekly PIH sessions. Individualised goals were assesed using Goal Attainment Scaling (GAS; -3 to + 2) at baseline and sessions 6, 10, and 15. Combined average GAS (c-GAS) were calculated per participant. Changes over time were analysed using the Friedman test with Bonferroni-corrected post hoc comparisons. Clinically significant improvement was defined as c-GAS ≥ 0. Data from 32 adolescents were analysed (mean age 13.8 years; 56
Internally displaced children are among the most vulnerable populations affected by armed conflict, often enduring psychological trauma that may lead to emotional dysregulation and post-traumatic stress disorder [PTSD]. This study aimed to assess emotion regulation among internally displaced children in Sudan and evaluate its relationship with PTSD symptoms. A cross-sectional, community-based study was conducted between July and September 2024, including 703 internally displaced children aged 8–18 across five Sudanese cities. Data were collected through structured caregiver-reported and child-reported instruments, including the Children’s Emotional Management Scales [CEMS] and the Children’s Revised Impact of Event Scale [CRIES-8]. Associations between emotion regulation subscales and PTSD symptoms were statistically analyzed using Wilcoxon Rank Sum, Welch’s Anova, and Chi-square tests, followed by multivariable logistic regression to identify independent predictors of PTSD. The prevalence of PTSD symptoms was 74.4
Although previous studies have examined associations among academic stress (AS), hostile self-criticism (HSC), and nonsuicidal self-injury (NSSI), the temporal directionality of these relationships remains underexplored. The present longitudinal study investigated the temporal dynamics among these constructs and examined whether these associations differed between Chinese and Belgian adolescents. A 6-month longitudinal study was conducted with 596 Chinese students (Mage = 15.05, SDage = 1.27) and 213 Belgian students (Mage = 14.22, SDage = 1.57), with measurements taken at 3-month intervals. The Random Intercept Cross-Lagged Panel Model revealed no significant between-person associations among AS, HSC, and NSSI. The only significant cross-lagged effect was that higher HSC predicted increased NSSI frequency 3 months later. In addition, no significant differences were found between China and Belgium in any autoregressive or cross-lagged paths at the within-person level. The present study deepens understanding of the temporal dynamics among AS, HSC, and NSSI, while suggesting that hostile self-criticism may be a particularly important prospective correlate of later NSSI. Academic stress appeared more as a concurrent contextual factor than as a robust prospective predictor.
The COVID-19 pandemic has resulted in significant disruptions to the daily routines of children, potentially altering trends in psychiatric diagnoses and medication utilization. This study investigates longitudinal changes in psychiatric diagnoses and the usage of psychotropic medications, thereby offering valuable insights into the developmental patterns of vulnerability among children and adolescents in the aftermath of the COVID-19 pandemic. This population-based, cross-sectional study utilized electronic medical records from Clalit Health Services (2016–2023). For each calendar year, data from approximately one million children and adolescents aged 5–18 years were analyzed. The study compared quarterly dispensing rates of antidepressants, antipsychotics, and psychostimulants, as well as the quarterly incidence of major psychiatric diagnoses, across pre-pandemic, pandemic, and post-pandemic periods. Poisson regression models, adjusted for seasonality, were employed to calculate counterfactual quarterly rates based on historical trends, thereby assessing the impact of the pandemic. During the pandemic, antidepressant dispensing exceeded expected levels, with the most pronounced increases observed among adolescents, particularly females (Relative Risk (RR) = 1.13). Conversely, psychostimulant dispensing initially declined (RR = 0.87) before rebounding following the pandemic. The use of antipsychotics exhibited modest and ongoing increases among young boys and adolescent girls, remaining elevated compared to pre-pandemic trends (RR 1.14–1.18). The incidence of diagnoses for Attention Deficit Hyperactivity Disorder (ADHD) increased across all demographic groups. Additionally, adolescent females experienced notable surges in anxiety (RR = 1.40), depression (RR = 1.49), and eating disorders (RR = 1.86). Many of these outcomes persisted at levels exceeding pre-pandemic forecasts during the post-pandemic period. The pandemic was associated with age- and sex-specific changes in paediatric mental health, with persistent increases in internalising disorders and antipsychotic use. These patterns, particularly pronounced among adolescents, suggest heightened developmental sensitivity to large-scale environmental stressors and underscore the need for targeted service planning and ongoing monitoring.
Substance use and traumatic experiences have been identified as risk factors for suicidal ideation and behavior in community samples. The aim of this study was to explore these associations in a clinical sample of adolescents with substance use disorder (SUD). The sample included N = 342 adolescents aged 12 to 19 years from a specialized SUD outpatient unit. They reported on their substance use, trauma history, symptoms of posttraumatic stress disorder (PTSD) and depression, and life satisfaction either in a structured clinical interview or standardized questionnaires; they also completed a task assessing inhibitory control. These variables were compared for adolescents with and without suicidal ideation or behavior. Classification and Regression Trees (CART) models were developed to describe subgroups of participants. Overall, 34.2
The paucity of valid and reliable tools for assessing the severity of suicidal ideation in adolescents is an impediment to youth suicide prevention efforts. This study aimed to examine the psychometric properties of the Suicidal Ideation Attributes Scale (SIDAS), a brief scale of suicidal ideation, in a large community-based sample of adolescents. Data for the current study was drawn from the baseline, 6–week, and 12–month follow–up surveys from the Future Proofing study, a prospective cohort study of adolescent mental health and wellbeing. This study includes 5885 adolescents (48
Children referred for forensic psychiatric evaluation represent a heterogeneous and vulnerable population comprising both victims and alleged offenders, who may differ substantially in their psychopathological and cognitive characteristics. Evidence from non-Western legal and cultural contexts remains limited, and few studies have applied complementary classical and machine-learning approaches to identify factors associated with post-traumatic stress disorder (PTSD) in this group. This study aimed to compare sociodemographic, clinical, and cognitive characteristics between victims and alleged offenders and to identify factors associated with PTSD. This retrospective cross-sectional study reviewed forensic psychiatric evaluation records of 420 children and adolescents, including 104 alleged offenders and 316 victims. Factors associated with PTSD were examined using logistic regression and complementary supervised machine-learning models with SHAP-based interpretation. Alleged offenders were significantly older and predominantly male, with higher rates of special education support, school dropout, medical comorbidity, attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), intellectual disability (ID), and specific learning disorder (SLD). Victims showed significantly higher rates of PTSD (19.4
Adolescents in Sierra Leone have endured successive crises including civil conflict, the 2014 to 2016 Ebola virus disease outbreak, and the COVID-19 pandemic, each compounding pre-existing vulnerabilities in mental health, education, and family stability. Despite growing global recognition of adolescent mental health as a public health priority, qualitative evidence documenting how young Sierra Leoneans experience distress, coping, and recovery remains limited. This study examined how adolescents in Sierra Leone experience mental health, well-being, coping, schooling, and post-crisis recovery. A qualitative participatory study was conducted across three districts in Sierra Leone between February and July 2024. Purposive sampling recruited 112 participants, including adolescents aged 13 to 19 years, caregivers, teachers, youth leaders, community health workers, counsellors, and child protection actors. Data were collected through in-depth interviews, focus group discussions, emotion mapping, personal timelines, and guided storytelling. Reflexive thematic analysis was applied. We identified four themes: (1) landscapes of distress, encompassing grief, fear, poverty-related shame, and school disruption; (2) gendered and intersecting vulnerabilities, including early marriage, sexual violence, and differential educational access; (3) coping, resilience, and meaning-making through faith, peer solidarity, creative expression, and aspiration; and (4) navigating support, revealing trust barriers, stigma, and the centrality of informal networks. Adolescent mental health in Sierra Leone is shaped by layered, intersecting crises that exceed individual-level coping. School-based psychosocial support, community-level stigma reduction, and gender-responsive services are urgently needed.
Self-harm is an important risk issue in child and adolescent mental health. Previous research has shown that family relationships and parental support are closely associated with self-harm among children and adolescents. However, father involvement is usually treated as a global construct, and its internal dimensional differences as well as their heterogeneous associations with self-harm remain insufficiently examined, particularly in the context of rural children in China. Using a publicly available dataset on rural children in China, we treated “deliberately hurt oneself during the past year” as a binary outcome and estimated two sets of sequential binary logistic regression models. The first set examined the association between the total father involvement score and child self-harm. The second set further decomposed father involvement into five dimensions—rule teaching, life care, academic support, emotional communication, and recreational involvement—and sequentially adjusted for individual-, family-, and peer-level variables. The prevalence of self-harm was 24.7
Armed conflict exposes adolescents to sustained environmental stressors that may influence emotional well-being and developmental trajectories. Despite increasing concern regarding youth mental health in conflict settings, systematic psychometric characterization of emotional distress and exposure to adverse life events remains limited, particularly in active conflict settings. This study aimed to assess emotional distress, emotional state, and exposure to adverse life events among Ukrainian adolescents, and to examine associations between psychological symptoms and cumulative adversity. This study was designed as an exploratory, cross-sectional analysis. Self-reported psychometric data were collected from 43 adolescents across two cohorts assessed in 2024 (n = 15) and 2025 (n = 28). Emotional distress was measured using the Depression Anxiety Stress Scales (DASS-21), emotional state using the Emotional State Assessment Tool (ESAT), and adversity exposure using the Life Events Checklist for DSM-5 (LEC-5). After data cleaning and harmonization, descriptive statistics, symptom severity distributions, and Spearman rank-order correlations were conducted to examine relationships between psychological measures. Across cohorts, more than half of participants reported depression, anxiety, or stress scores above the normal range. The proportion of participants scoring above the normal range for depressive symptoms was higher in the 2025 cohort (71.4
Sensory over-responsivity (SOR) is an impairing sensory processing challenge prevalent across a range of clinical and neurodevelopmental populations, as well as those with experiences of early caregiver-related adversity. Despite its prevalence and impairing nature, little research exists investigating SOR, and its distinct, underlying neural mechanisms, in early caregiver-related adversity. We examined SOR in children and adolescents ages 7–17 years old who were adopted from foster care (AFC; n = 31) and non-adopted comparisons (NAC; n = 26). Using functional magnetic resonance imaging, we investigated neural activity and functional connectivity in response to mildly aversive auditory and tactile stimulation and its relationship to SOR. The AFC group had elevated SOR scores as well as greater activation in somatosensory cortex compared to NAC. Within the AFC group, those with lower SOR showed increased activation of subcortical (thalamus, amygdala, hippocampus) and cortical (pre- and post-central gyri, and cingulate gyrus) regions. In the AFC group, negative functional-connectivity was observed between prefrontal and sensory regions, across sensory regions, and between sensory regulation and sensory reactivity-related regions. While sensory-evoked activation results suggest that children with early caregiver-related adversity show some hyperactivity to aversive sensory stimulation, consistent with other clinical groups, connectivity analyses suggest additional, unique mechanisms of SOR. Furthermore, functional-connectivity results provide evidence that children with early caregiver-related adversity may develop compensatory mechanisms that contribute to resilience for SOR. Results help explain individual differences in SOR in youth with early caregiver-related adversity and suggest a potential neural basis for some resilience to more severe SOR in these youth.
This perspective article introduces Gender Affirming Psychiatry (GAP), a conceptual framework that integrates queer phenomenology, the gender minority stress model, and gender-affirming care to guide psychiatric assessment, formulation, and treatment of transgender and gender diverse (TGD) youth. This approach acknowledges the cultural and institutional structures that negatively impact the mental health of gender diverse youth, while leveraging resilience, community connection, and support structures that are known to improve mental health outcomes. In this time of greater awareness and increased scrutiny, GAP is a practical, person-centered approach that is clinically sound and ethically grounded.
Adolescent addictive behaviors present a growing public health concern, yet the pathways leading from experiences of disconnection to persistent addictive patterns remain unclear. This study examined the Sense of Absence (SoA), a subjective feeling of inner void and disconnection, as a potential bridge linking relational deprivation with addictive behaviors. This cross-sectional study used network analysis and was conducted in Israel with a sample of 2,564 adolescents’ communities. Participants completed a sense of absence, relational tendencies (parent-adolescent communication, attachment avoidance, attachment anxiety) and addictive behaviors (alcohol, drugs, internet gaming disorder, problematic social networks use, smartphone addiction, shopping addiction, problem gambling, problematic pornography use, compulsive sexual behavior). Bridge centrality analysis indicated that SoA exhibited the highest bridge strength across all nodes, exceeding direct relational to addiction connections. Connection density analysis showed that SoA had the strongest cross domain connectivity, whereas direct edges between relational and addictive domains were relatively sparse. SoA also showed stronger associations with relational factors than with addictive behaviors. Overall, the findings suggest that SoA occupies a central structural position in the network linking relational tendencies and addictive behaviors.
This study aimed to examine the developmental trajectories and longitudinal associations among loneliness, non-suicidal self-injury (NSSI), and mobile phone dependence in adolescents. A three-wave longitudinal survey was conducted over three years, with approximately 12-month intervals. A total of 941 first-year junior high school students completed the Adolescent Non-suicidal Self-injury Assessment Questionnaire (ANSAQ), the UCLA Loneliness Scale (ULS-20), and the Mobile Phone Dependence Index (MPAI). Latent growth modeling (LGM), cross-lagged panel models (CLPM), and competing model comparisons were applied to analyze the data. LGM indicated a significant decline in adolescents’ loneliness over time (slope = − 0.32, p < 0.05), whereas the trajectory of NSSI remained relatively stable. Cross-lagged analyses revealed reciprocal longitudinal associations between loneliness and NSSI (T1 loneliness → T2 NSSI: β = 0.150, p < 0.001; T1 NSSI → T2 loneliness: β = 0.162, p < 0.001). The findings further suggested significant longitudinal associations among loneliness, mobile phone dependence, and NSSI. Mobile phone dependence was also longitudinally associated with the relationship between loneliness and NSSI. Loneliness and NSSI were reciprocally associated across adolescence. Mobile phone dependence may be longitudinally linked with this relationship, highlighting the importance of considering adolescents’ digital media use alongside emotional experiences when developing prevention and intervention strategies for adolescent psychological adjustment and self-injurious behaviors.
Early adolescence marks a vulnerable developmental phase for the emergence of self-harm behaviours, which can potentially be life-threatening. However, the prevalence and risk factors of early adolescent self-harm, particularly in non-Western community-based populations, remain underexplored. This study investigated the prevalence and psychosocial correlates of self-harm in a multi-ethnic Asian cohort of 13-year-olds, an age when self-harm commonly emerges. Our sample of 666 participants was embedded in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort in Singapore. Self-harm history, suicidal thoughts and behaviour and exposure to others’ self-harm were assessed using the Risk-taking and Self-harm Inventory for Adolescents at 13 years of age. Parent- and child-reported psychopathology were assessed using the Child Behaviour Checklist, Children’s Depression Inventory, and Multidimensional Anxiety Scale for Children across multiple time points in childhood. By age 13, 20
BACKGROUND:Since the beginning of the Russian war against Ukraine in 2022, various evidence-based trauma-focused therapies have been implemented in a region that was previously structurally underserved. Despite the high demand for psychotherapeutic care, little is known about the practical implementation of these therapies under conditions of war. The aim of this qualitative study was to explore the experiences of Ukrainian therapists in delivering Trauma-focused Cognitive Behavioral Therapy (TF-CBT) for children and adolescents during the war and to identify benefits, specific challenges and necessary adaptations. METHOD:In April 2023, three focus groups were conducted with a total of seven Ukrainian therapists who were part of the "TF-CBT Ukraine" project. The focus groups were transcribed, translated into English, and analyzed using qualitative content analysis with MAXQDA. RESULTS:All participants had already initiated or successfully completed TF-CBT treatments and reported positive therapeutic experiences underscoring the acceptability and perceived benefit of the intervention under highly adverse conditions. At the same time, a range of challenges was identified, including an unstable security situation, unreliable internet connections, frequent relocation of clients, and difficulties in working with parents. Therapists discuss possible reasons for this, like the parents' own psychological burden or the limited mental health literacy within the general population. Therapists described specific adaptations in their therapeutic practice to address these challenges, including adjustments to pacing, and enhanced efforts in psychoeducation and stabilization. CONCLUSION:The findings indicate therapists perceive TF-CBT as generally feasible under conditions of war, highlighting its robustness as an evidence-based intervention in humanitarian settings. However, the results also emphasize the necessity of context-specific adaptations to address ongoing instability, structural barriers, and sociocultural factors. Beyond the Ukrainian context, these findings provide valuable implications for the implementation and scaling of trauma-focused interventions in other war- and crisis-affected regions. They further underscore the importance of sustained training, supervision, and support for therapists to ensure treatment fidelity, as well as the need to integrate mental health literacy initiatives at the community level to maximize both effectiveness and long-term sustainability.
