Editor’s Choice Articles

Bullying and cyberbullying share in their definition the pattern of aggressive and intentional conduct, characterized by a perceived or observed imbalance and repeated over time. Empathy and emotional intelligence are fundamental individual skills that can enable adolescents to develop less aggressive and more empathetic behaviors. The aim of this study is to explore the frequency of bullying and cyberbullying (victimization and/or aggression), the association of bullying, cyberbullying, empathy, and emotional intelligence, and to explore whether sex, age, educational level, and online recreational time are related to bullying and cyberbullying behaviors. A sample of 599 adolescents, aged between 13 and 21 years old, from basic and secondary schools located in the north of Portugal, participated in the study. The instruments used in the study were the Sociodemographic Questionnaire; the Bullying and Cyberbullying Behavior Questionnaire; the Basic Empathy Scale; and the Self-Perception of Emotional Intelligence Questionnaire. The main results indicated that victims demonstrate greater empathy and emotional intelligence. The results also showed that male adolescents take on more of the role of aggressors in bullying and cyberbullying, while female adolescents take on more of the role of victims. The study underscores the importance of developing and implementing prevention and intervention programs for bullying and cyberbullying, with a focus on promoting empathy and emotional intelligence among adolescents. Full article

Background: Intolerance of Uncertainty (IU) is a transdiagnostic factor measured using the Intolerance of Uncertainty Scale-Revised (IUS-R). This study evaluated the stability and change in adolescents’ IU over a three-month period using a modified version of the scale. Methods: A two-wave study was conducted, with 290 adolescents responding to an online survey at baseline and 199 at follow-up. The original IUS-R was modified to probe the rating of the current perceived state of IU, rather than typical experience. The link between IU variability and the development of interpretation bias in ambiguous social situations at follow-up was explored. Structural Equation Modeling and Linear Mixed Model analyses were performed to assess the longitudinal measurement invariance and responsiveness of the Modified IUS-R scale. Results: The scale demonstrated good psychometric properties and full measurement invariance. Individual participants showed significant variability in baseline IU levels but not in the degree of change. A reliable change in scores was observed in 8% of adolescents. The Modified IUS-R predicted interpretation bias in social situations at follow-up. Conclusions: Significant inter-individual-level variation in IU suggests this tool may be useful for detecting changes in IU and predicting significant health outcomes. Future studies should further address the assessment of changing IU with longer timeframes. Full article

Substance use is a growing problem among young people in sub-Saharan Africa who increasingly adopt the habit of smoking cigarettes. The aim was to analyse prevalence rates and identify predictors for cigarette smoking among school-attending adolescents in Bissau, Guinea-Bissau. In June 2017, a survey questionnaire was implemented in 16 schools in a class-based, random sample of 2039 adolescents aged 14–19 (52% girls). The chi-square (p < 0.05) and odds ratios (OR) were calculated with 95% confidence intervals (CI). Potential explanatory variables for the dependent variables were introduced into a multinomial logistic regression model, and p-values were transformed to LogWorth values. The prevalence rate for lifetime smoking experience was 14.8%, 4.0% for occasional smoking (<30 days), and 2.4% for daily smoking. The most significant predictors for cigarette smoking included having friends who smoke, being a boy, attending a private school, smoking initiation at a young age, other substance use, and violent behaviour. It is imperative to initiate preventive actions against smoking and other use of tobacco in Guinea-Bissau. Considering the significant impact of the peer group, policymakers need to engage young people in developing primary prevention strategies to curb the use of tobacco and other substances. Full article

Virtual reality (VR) can help to prevent alcohol consumption by simulating peer pressure. While existing VR applications for adolescents are primarily tested in schools, expanding them to museums and art galleries offers setting-specific benefits and could enhance their reach. An interactive VR simulation was presented in an art exhibition on substance use reflection. This study aimed to (1) describe visitor experiences with the simulation and (2) analyse differences according to gender and age. Visitors (n = 293) explored Virtual LimitLab for about 15 min before completing a survey on user experience and perceived learning experiences, which also included open questions on its positive and negative aspects. The quantitative user experience and perceived learning experience items were rated positively, except for knowledge increase. Young visitors (≤18 years of age) perceived Virtual LimitLab as more interesting (p = 0.043) and exciting (p = 0.047) than older ones. Female visitors rated the reflective response (p = 0.016) and sensitisation to social pressure (p = 0.024) higher than males. The qualitative evaluation showed that visitors appreciated the simulation’s realism, authenticity and adaptability. VR-based public health interventions in the arts setting need further research to study their preventive potential. Full article

Sexual debut among young adolescents is under-investigated. In this quantitative descriptive study, we examined the 2019 Middle School Youth Risk Behavior Survey (YRBS) data of 66,366 young adolescents aged 10–14 from 10 states to determine the prevalence of early sexual debut among young adolescents. Data analyses used state-level sampling weights as described in the CDC’s 2019 Middle School YRBS user guide. Nearly 8% of the sample reported having had sexual intercourse. Of those who reported age of first sex, 4% had their first sexual intercourse before 13 years of age. Compared to Whites, young Black/African American (13.2% vs. 5.1%, OR = 4.51, 95% CI: 2.78–7.31) and Hispanic adolescents (8.3 % vs. 5.1 %, OR = 1.44, 95% CI = 1.13–1.84) were more likely to report having early sexual intercourse. Males were more likely to report having multiple sexual partners than females (48.1% vs. 36.5%, OR = 1.68, 95% CI = 1.22–2.29) and were more likely to report using condoms during their last sexual intercourse compared to their female counterparts (59.7% vs. 50.8%, OR = 1.43, 95% CI = 1.06–1.94). This study suggests the need for more research on young adolescents’ sexual behaviors and for the development of sexual health interventions that target young adolescents. Full article

Background: Cyberbullying and nighttime phone use are independently detrimental to sleep and psychological wellbeing, but whether in combination they might be more disruptive remains unknown. Methods: Students aged 7–19 years (N = 53,734) completed a survey measuring sleep duration, nighttime phone use, cyberbullying, and psychological distress. Results: Across stratification variables of gender (F/M) and age group (primary/secondary-school-aged children), bivariate ordered probit regression revealed that being cyberbullied and nighttime phone use were independent predictors of both increased psychological distress and obtaining <8 h sleep. Nighttime phone use was observed to moderate the relationship between cyberbullying and sleep in both primary- and secondary-school-aged girls and boys and, likewise, between cyberbullying and psychological distress, especially in secondary-school-aged boys. Notably, the moderation effect was such that the impact of nighttime phone use was lower in children who were compared with those who were not cyberbullied. This may be a ceiling effect due to the high number of cyberbullied children reporting shortened sleep and higher levels of psychological distress. Discussion: The present findings point to a possible role of nighttime phone use as a moderator of the effect of cyberbullying on sleep and psychological wellbeing. There is a need for future studies to better explore more directly the effects of cyberbullying during the nighttime. Full article

Individuals with eating disorders often face difficulty accessing sufficiently intensive, recovery-focused treatment. Residential treatment may fill a gap in the spectrum of care, offering 24-h support in a more home-like environment than a hospital and using a holistic approach including individual and group psychological therapy, meal support, and lived experience staff. As residential treatment has not previously been examined in Australia, the current study aimed to document the development, treatment components, and structure of this first Australian residential service for eating disorders and provide a pilot of its treatment outcomes. Preliminary outcomes are included from a sample of 19 individuals from the first six months of admissions, including eating disorder symptoms, eating disorder-related impairment, anxiety, and depression. Significant pre- to post-treatment improvement was found in total eating disorder psychopathology, dietary restraint, eating concerns, body mass index, eating disorder-related impairment, and depression, but not from pre-treatment to a six-month follow-up. Pilot outcomes were positive at end-of-treatment but require further clinical evaluation to examine follow-up effects. Clinical insights are discussed from the establishment of this new treatment service, including recommendations for clinicians involved in the current roll-out of residential programs across Australia. Full article

After the spread of the COVID-19 pandemic, several articles have described the fragility of young adults, such as students, highlighting the severity, frequency, and nature of mental distress. However, less research has examined the resources of young people, such as their creative competence and their ability to draw on a social network. Furthermore, the analysis of these resources is not very common in international comparative studies. The main aim of this cross-national study is to investigate whether creativity factors such as creative personality and divergent thinking together with social support predict resilience in college students, controlling for gender and nationality, in a sample of college students from Italy and Spain, European Mediterranean countries particularly affected by the pandemic. The following instruments were used to measure these constructs: The Creative Personality Scale, the Runco Ideational Behavior Scale, the Multidimensional Scale of Perceived Social Support, and the Connor Davidson Resilience Scale. A total of 287 college students participated, 147 from Italy and 140 from Spain, with an average age of 22 years. The results show that there are statistically significant differences between Italian and Spanish students for all variables except resilience. The hierarchical regression shows that divergent thinking and social support are predictors of resilience for the whole sample. In light of these results, it may be important for universities to continue investing in divergent thinking and social support through workshops and activities to promote student resilience. Full article

During the COVID-19 pandemic, young people have become overexposed to social media and online gaming, making them more vulnerable to online violence such as cyberbullying. The aim of this study was to determine whether social media and online gaming pose a risk for cyberbullying through time spent online and whether there is a sex that is more vulnerable to this phenomenon. The survey included a sample of 4338 students (52.4% girls; age range, 11–19 years, M 14.1 SD 1.6) attending lower and upper secondary schools. Multiple moderated mediation regression models by sex were conducted, showing a relationship between social media and online gaming, time spent online outside of school, and cyberbullying. The results show that young girls are at higher risk of cyberbullying via social media, and boys are at higher risk of cybervictimization through online gaming. The findings may encourage other researchers to study the phenomenon, taking into account the role of parents and other educators. Full article

HIV disparities continue to persist among Black youth in the South. We conducted quantitative surveys (N = 83) and follow-up qualitative interviews (n = 13) to assess sexual health needs including but not limited to Pre-Exposure Prophylaxis (PrEP) awareness. Participants all identified as Black; most survey respondents identified as being assigned female sex at birth and heterosexual. Both qualitatively and quantitatively, knowledge about HIV and PrEP and engagement in sexual health preventive behaviors was low. Participants described a need for more comprehensive sexual health education at younger ages and more routinized HIV testing. The latter was recommended even for people with a low perceived risk of HIV. Future studies should explore how to tailor communication to youth of color specifically and understand nuances of experiences they may have based on their sexual orientation and gender identity to promote engagement in sexual health preventive care, including but not limited to HIV prevention and PrEP uptake. The findings suggest that comprehensive sexual care that provides education on HIV, STI, and pregnancy prevention is critical for youth experiencing inequities in a Southern city context. Full article

The marketing of sweetened and flavoured tobacco in the early 1990s resulted in an upsurge in waterpipe smoking (WPS), mainly among young people and women. Here, we estimate prevalence rates among school-attending adolescents aged 14–19 (girls 52%) for a lifetime experience of WPS and within the last 30 days (WPS < 30 days) and identify influential factors for such smoking in Bissau, Guinea-Bissau. A random sample (N = 2039) was drawn from a class-based register created for 16 schools in Bissau; attending students in June 2017 were invited to respond to a locally adapted Planet Youth questionnaire. Descriptive statistics, odds ratio with 95% confidence interval, and multinomial logistic regression analysis were used to identify influential factors for WPS. The prevalence rates for a lifetime experience of WPS and within < 30 days were high, 17.7% and 15.0%, respectively, with no significant gender difference. For both groups, a multinomial logistic regression analysis identified attending higher grades in school, use of alcohol and being a victim of sexual violence as significant, influential factors. The overlapping of influential factors suggests preventive work against substance abuse should focus on less stigmatising behaviour, such as WPS and firmer implementation of the Framework Convention of Tobacco Control (FCTC). Full article

The aim of this study was to determine whether adolescents’ emotional problems, coping flexibility, age, and stress appraisals account for ways of coping, which include engagement and disengagement coping, with academic-, parent-, and peer-related stressful events. Stress appraisals were defined as perceived threats to the psychological needs of relatedness, competence, and autonomy. Models were fit at a higher order level, indicated by adolescents’ appraisals and intended ways of coping with stress in three domains (i.e., academic, parent, and peer) and tested at the lower level within each domain. Adolescents (N = 410; age 10–15; Mage = 12.5; 50% girls) reported their emotional problems (combined depressive and anxiety symptoms) and coping flexibility six months prior to completing an analogue task. The task involved viewing six short film clips portraying stressful events (e.g., obtaining a worse than expected exam grade or arguing with a parent) and reporting three stress appraisals and eight ways of coping after each stressor. The ways of coping were analyzed as four composite scores reflecting engagement coping (active coping, self-reliance) or disengagement coping (withdrawal coping, helplessness). In structural equation models, adolescents who appraised more threat reported more withdrawal coping and helplessness but also more active coping and self-reliance. Adolescents with more emotional problems appraised more threat and anticipated using less constructive ways of coping, whereas adolescents higher in coping flexibility intended to use more constructive ways of coping, with these associations sufficiently modeled at the general (across stress domains) level. Improvement in the model fit was found when appraised threat–coping associations were modeled at the lower (specific stressor domain) level, suggesting differences by stressor domain. Age was associated with more self-reliance and helplessness, with self-reliance being specific to parent stressors and helplessness specific to peer stressors. Full article

The social and emotional health of adolescents is increasingly a concern worldwide. To date, there remains a lack of research on how school climate influences adolescents’ learning experiences and their social and emotional health. To address this gap in the literature, this critical review addresses the role that the school climate plays in an adolescent’s school life and emotional well-being. This article takes a critical approach and outlines the key issues in research on the secondary school climate in the digital and real-life sense and the implications for adolescent’s well-being. We first outline the definitional and methodological issues regarding research on school climate in adolescence. We then outline why mental health is a key issue for adolescents across the globe and conclude with a list of implications for theory, research, and practice. Thus, this article builds on past, current, and ongoing research on adolescents’ emotional well-being and school climate across the globe. The article provides new directions and recommendations for future research on inclusive educational philosophies and positive psychology and suggestions for practice aimed to best support adolescents’ learning experience and mental well-being. Full article

Direct experiences of sexual harassment have been found to be associated with substance use and poor mental health among girls. Indirect experiences, such as witnessing the sexual harassment of others, may be indicative of a climate supportive of sexual harassment against girls and elicit similar adverse outcomes. The current study sought to assess reports of witnessing sexual harassment and associations with substance use and mental heath outcomes among adolescent girls. The data were from questionnaires among girls (n = 152) ages 15–19 recruited from a health clinic serving a low-resource community in San Diego County. Using crude and adjusted regression models, we assessed witnessing the sexual harassment of girls (past year) as well as the frequency of witnessing such acts in relation to substance use, anxiety, depression, and suicidal ideation. The adjusted models included demographics and direct experiences of sexual harassment (past 6 months) as covariates. The participants had an average age of 17, and 76% were Latina. The majority (70%) reported witnessing sexual harassment (past year); 65% reported directly experiencing sexual harassment (past 6 months). Among those reporting witnessing, most witnessed sexual harassment at school (69%), at a party (45%), in their neighborhood (34%), or on public transport (33%). In adjusted logistic regression models, witnessing sexual harassment was significantly associated with past 30-day alcohol use, ever using drugs, feeling depressed (past 30 days), feeling anxious (past 30 days), and past-year suicidal ideation (ORs range 2.9–18.2). The findings suggest that, in addition to direct experiences of sexual harassment, indirect experiences of witnessing the sexual harassment of others may also be associated with negative outcomes regarding girls’ health and well-being. Full article

Background: Over 40 years of research implicates perfectionism in eating disorders in childhood and adolescence. However, the nature of this relationship remains understudied. To address this gap, we performed a systematic review and a meta-analysis to quantify the magnitude of the associations between perfectionism (i.e., unidimensional perfectionism, perfectionistic strivings, and perfectionistic concerns) and eating-related symptoms during childhood and adolescence. Methods: The literature search was conducted using five electronic databases in accordance with PRISMA guidelines: MEDLINE, Embase, CINAHL Complete, APA PsycINFO, and EMB Reviews. A total of 904 studies were identified; a total of 126 were included in the systematic review, and 65 in the meta-analysis (N = 29,268). Sensitivity analyses were also carried out to detect potential differences in age and clinical status. Results: All the associations we investigated were both significant and positive. Small effect sizes were found between eating global scores and unidimensional perfectionism, perfectionistic strivings, and perfectionistic concerns (r_es = 0.19, r_es = 0.21, r_es = 0.12, respectively) and remained significant in each age group in both clinical and community samples. Perfectionistic concerns were moderately associated with all eating measures, especially in community samples and samples with a mean age under 14. Conclusions: Psychological interventions specially designed to target perfectionistic concerns in the early stages of development may help prevent the onset or reduce the intensity of eating-related symptoms during childhood and adolescence. Full article

Teen pregnancy is often considered an adverse health outcome that accentuates gender inequities, diminishes opportunities, and jeopardizes the safety of adolescent and young adult birthing people. Long-Acting Reversible Contraceptives (LARC) have been hailed as a panacea for teen pregnancy. However, adolescents and emerging adults intersect with multiple assaults on their health and well-being due to gender inequity and racism. To establish equitable care, it is imperative to discern all barriers that influence their reproductive autonomy. This study evaluates the measurement, operationalization, and quality of research conducted on adolescents and emerging adults that analyzed the use of LARC within the social determinant of health framework (SDOH) in the US. SDOH were assessed using the Dahlgren and Whitehead model, and reports were analyzed using a modified version of the Joanna Briggs Institute (JBI) Critical Appraisal tools. Nineteen articles were included in this study. Researchers found the insufficient measurement of race, ethnicity, sexuality, and gender among studies on LARC and SDOH in adolescents and emerging adults. Future studies must measure a full range of identities in data collection to generate knowledge on the impact of SDOH and LARC use among diverse populations. Full article

Bullying is a widespread public health problem with significant behavioral and mental health consequences. The current study tested the effectiveness of combining interactive digital material for students, educators, and parents with class sessions to prevent bullying among middle school students. Fourteen middle schools were randomly assigned to intervention and comparison conditions. Both conditions received a classroom-based drug and violence prevention program that taught social skills, self-management skills, and social resistance skills. The intervention condition included class material on bullying and an educational video game for students that reinforced the classroom program; it also included digital material on bullying for parents and school staff. All students completed online pre- and post-test surveys to assess bullying-related behavior, knowledge, and life skills. Results indicated that students in the intervention schools reported significantly less bullying and cyberbullying perpetration and increased life skills knowledge relative to comparison schools. This study provides evidence that a school-based drug abuse and violence prevention program, when enhanced with a set of digital tools for students, parents, and school staff, holds considerable potential for addressing bullying among middle school adolescents. Full article

Background: Adolescence is a critical developmental period for mentalization and emotion regulation skills. Studies show that during this time, adolescents may experience greater vulnerability to challenges of mental and emotional well-being. Studies also show that self-skills, such as mentalization, self-compassion, and self-control are independently associated with feelings of global self-worth or psychological well-being. To date, no known studies have explored interconnected relations among these self-skills, despite significant overlaps in the social-biological development of these skills. Aims: To investigate interconnected relations among psychological well-being, mentalization, self-compassion and self-control. Gender differences in these relations are explored. Method: As part of a larger, longitudinal study of adolescent well-being, this cross-sectional study drew on a variety of self-report measures, investigating relations among adolescents’ self-reports of psychological well-being, emotion recognition, self-control, and self-compassion. Participants consisted of 88 girls and 57 boys, mean age 13.38. Results: Main results showed associations among emotion recognition, self-control and self-compassion and feelings of global self-worth. Specifically, results showed that understanding negative emotions in others relates to lower levels of self-compassion and feelings of self-worth. Further, adolescents who report low levels of self-control reported uncompassionate self-responding and lower levels of self-worth. Gender differences and implications for further research and adolescent social-emotional interventions are discussed. Full article