Search Results (1,203)

Pornography use during adolescence is a relevant issue from social, educational, and public health perspectives. As with other behaviours, its correlates may involve complex and nonlinear relationships. This study uses data from the 2023 Spanish Survey on Drug Use in Secondary Education (ESTUDES), a major source for analysing potentially addictive behaviours among adolescents in Spain because of its large sample size (original sample: N = 42,208; complete-case analytical sample: N = 33,543). Pornography use was modelled as a binary outcome using logistic regression, XGBoost, LightGBM, and CatBoost. The models included sociodemographic characteristics, family-related factors, parental control, substance use, selected sexual behaviours, indicators of mental well-being, and addictive Internet use. The four methods showed similar predictive performance. CatBoost achieved the highest AUC and the lowest Brier score and log loss, whereas LightGBM obtained the highest accuracy, specificity, and precision. Logistic regression yielded the highest sensitivity, negative predictive value, balanced accuracy, and F1-score. SHAP analysis identified sex as the most influential predictor, followed by addictive Internet use, cannabis and alcohol use, family conflict, and selected risky sexual behaviours. The findings suggest that pornography use among adolescents forms part of a broader behavioural and psychosocial profile. Whereas sex operated mainly as a strong direct predictor, problematic Internet use showed substantial interactions with age and cannabis and alcohol use. This study demonstrates how explainable machine learning can complement conventional regression by identifying the main correlates, nonlinear patterns, and interactions associated with adolescent pornography use. Full article

Background/Objectives: The transition to early parenthood is a pivotal phase influencing maternal mental health. Although parenting competence may support maternal adjustment, it is often treated as a unitary construct. This study examined the associations among foundational caregiving competence, developmental parenting and interaction competence, and eudaimonic parental well-being in first-time mothers. Methods: A cross-sectional survey was conducted with 372 first-time mothers whose young children attended licensed infant daycare centers in northern Taiwan. Participants completed questionnaires regarding the three study constructs and demographic characteristics. Data were analyzed using descriptive statistics, Pearson correlations, and partial least squares structural equation modeling. Results: Foundational caregiving competence was strongly associated with developmental parenting and interaction competence, which was positively associated with eudaimonic parental well-being. The direct association between foundational caregiving competence and eudaimonic parental well-being was not statistically significant after developmental parenting and interaction competence was included in the model. However, a significant indirect association was observed through developmental parenting and interaction competence. Conclusions: Relational, developmental, and role-oriented parenting competence was more closely associated with mothers’ experiences of meaning, fulfillment, and relational satisfaction than practical caregiving competence alone. Given the cross-sectional design and modest explanatory power, the findings represent preliminary associations rather than causal evidence. They may inform future parenting-support services that distinguish practical caregiving capacities from relational and developmental parenting competencies. Full article

Depression has been a pressing mental health concern among contemporary adolescents. Accumulating evidence suggests that individuals’ circadian preference—chronotype—may be associated with adolescent depression, yet the potential mediating and moderating roles within this association have received limited attention in existing research. The present study aimed to examine the relationship between chronotype and depression among adolescents, as well as the mediating role of bedtime procrastination and the moderating role of parental psychological control. A cross-sectional study was conducted among 4324 adolescents (63.9% female; mean age = 16.24 ± 0.92 years) using a questionnaire survey method. All participants completed self-report measurements, including the Composite Morningness Questionnaire (CMQ), Bedtime Procrastination Scale (BPS), Patient Health Questionnaire-9 (PHQ-9), and Parental Psychological Control Scale (PPCS). The results showed that chronotype was significantly and negatively associated with depression among adolescents (β = −0.461, p < 0.001). Bedtime procrastination partially mediated the association between chronotype and adolescent depression (β = −0.257, 95%CI [−0.283, −0.232]), with a mediating effect size of 55.75%. Moreover, parental psychological control moderated the direct association between chronotype and depression (β = −0.043, 95%CI [−0.070, −0.016]), as well as the association between bedtime procrastination and depression (β = 0.120, 95%CI [0.092, 0.148]). Specifically, high levels of parental control were linked to a more pronounced relationship between chronotype and depression, as well as a stronger association between bedtime procrastination and depression. These findings advance our understanding of how chronotype is related to adolescent depression, and suggest that multilevel interventions targeting sleep hygiene practices and family dynamics may be promising for reducing depressive risk among vulnerable adolescents. However, given the cross-sectional design, future longitudinal or experimental studies are needed to establish temporal precedence and further test these associations. Full article

Background/Objectives: Postpartum depressive symptoms are a major maternal mental health concern associated with adverse outcomes for mothers and infants. Although biological, psychological, and social factors have been associated with postpartum depressive symptoms, limited evidence has examined their interrelationships within a theoretically grounded framework among Thai mothers. This study aimed to test a hypothesized Stress Process Model of factors associated with postpartum depressive symptoms among Thai mothers using structural equation modeling (SEM). Methods: A cross-sectional study was conducted among 462 Thai mothers attending routine 4–6-week postnatal follow-up clinics at three tertiary hospitals in Northern Thailand. Participants were recruited using proportional allocation and consecutive sampling. Data were collected between April and June 2025 using standardized measures of postpartum depressive symptoms and standardized measures of self-perceived burden, parenting stress, social support, self-esteem, mastery, and coping, together with demographic and clinical data. Data were analyzed using descriptive statistics and SEM. Results: Using the prespecified Edinburgh Postnatal Depression Scale cutoff score of ≥11, 30.95% of participants screened positive for probable postpartum depressive symptoms. The final structural model demonstrated acceptable fit to the data (χ²/df = 2.95, RMSEA = 0.07, CFI = 0.94, TLI = 0.92, and SRMR = 0.05) and explained 65.10% of the variance in postpartum depressive symptoms. Self-perceived burden and parenting stress showed significant positive direct associations with postpartum depressive symptoms, whereas social support showed significant inverse direct and indirect associations. Perinatal complications were directly associated with postpartum depressive symptoms and indirectly associated through self-perceived burden and parenting stress. Mastery also showed a significant inverse indirect association. Conclusions: The findings support theoretically specified associations consistent with the Stress Process Model. Because all variables were assessed concurrently, the identified pathways should be interpreted as statistical associations rather than evidence of temporal ordering or causal mechanisms. Full article

Background/Objectives: While there is an existing body of quantitative data on the psychological and mental burden of suicide-bereaved parents, further qualitative research is needed to explore suicide-bereaved mothers’ living experiences in specific sociocultural contexts, especially in Southern Europe and the Eastern Mediterranean. Given the persistent stigma surrounding suicide in these societies, and the fact that previous research has often overlooked mothers’ perspectives in favor of broader samples of bereaved parents, we explored the psychosocial needs of Greek-speaking suicide-bereaved mothers in the Republic of Cyprus, and their experiences in accessing formal mental healthcare support. Methods: An inductive, secondary content analysis of qualitative data collected through personal semi-structured interviews with ten suicide-bereaved mothers was employed. Results: Participants’ psychosocial needs centered around a “persistent orientation towards protection,” encompassing three interconnected domains: (1) self-protection and the need for acceptance by shielding themselves from stigma, social judgment, and emotional disintegration, (2) ensuring a safe and protective environment for the surviving family by safeguarding the psychological well-being and cohesion of surviving family members, and (3) protecting the posthumous dignity and memory of the deceased child. Rather than seeking formal support, participants overwhelmingly avoided mental health services, citing a lack of empathy, cultural misunderstanding, and fear of further stigmatization. Mental health professionals were often perceived as inadequate or even harmful, undermining participants’ need for protective attitudes, self-reliance and self-respect during bereavement. These responses reflected how stigma and gendered social expectations surrounding suicide shaped participating bereaved mothers’ disengagement from the healthcare system, despite their intense psychological needs. Conclusions: These findings underscored how gendered social expectations, combined with the stigma surrounding suicide, created significant psychosocial barriers to mental health care for women navigating traumatic grief, particularly in sociocultural contexts where suicide remains highly stigmatized. Full article

Background/Objectives: Adolescent somatic symptoms such as headache, irritability, and sleep difficulties are common and closely tied to adolescent mental health, yet they are typically studied as a single dimension and as individual complaints detached from the psychosocial adversity surrounding the adolescent. Drawing on the nationally representative 2022 Türkiye Child Survey (n = 3523, ages 13–17), we examined whether these symptoms are patterned by the psychosocial risk and support surrounding the adolescent. Methods: Measurement models, multiple correspondence analysis, survey-weighted ordinal regression, a mixed graphical model, and machine-learning algorithms were applied in sequence. Results: Somatic symptoms were organized around a dominant general factor, alongside closely correlated physical and psychological dimensions that showed differential external associations. The three relational microsystems formed a coherent psychosocial adversity gradient along which somatic burden increased. The two dimensions were linked to different factors: peer victimization, a risk factor, and parental support, a protective factor, were associated primarily with psychological burden (odds ratios per standard deviation 1.84 and 0.88), whereas female sex and chronic illness were linked more strongly to physical burden (2.35 and 1.61); body mass index, income strain, and housing problems showed no independent associations. Regression, network, and machine-learning analyses converged on this dissociation while indicating modest individual-level predictability. Conclusions: Adolescent somatic symptoms are thus systematically patterned by psychosocial risk and support at the population level, an association that may inform monitoring and psychosocially informed assessment rather than individual prediction, and that requires longitudinal work to interpret directionally. Full article

Adolescence is a developmental period characterized by increased exposure to stress and elevated vulnerability to mental health problems. The present study examined the structure of perceived stress, its longitudinal stability, and its associations with mental health in adolescents. Data were collected from a probabilistic sample of 1679 Croatian adolescents who were in the first or second year of high school at baseline and were followed across three measurement waves approximately six months apart. Perceived stress was assessed across six domains (school, future, parents, friends, romantic partners, and self), and structural equation modeling was used to test factor structure, measurement invariance across time and sex, and temporal stability. Competing models supported a hierarchical structure comprising six domain-specific factors and a higher-order general perceived stress factor. The measure demonstrated strong longitudinal and sex invariance. General perceived stress showed high stability across the three waves, despite being assessed as a current subjective experience. Perceived stress was moderately to strongly associated with depression, generalized anxiety, internalizing and externalizing symptoms, life satisfaction, and happiness, with no evidence of sex differences in these associations. These findings suggest that adolescent perceived stress is best conceptualized as a hierarchical and highly stable construct that is closely linked to multiple indicators of mental health and well-being. Full article

Research has demonstrated the intergenerational effects of parents’ adverse and positive experiences. Despite growth in the literature, previous reviews have primarily focused on the intergenerational effects of parents’ childhood experiences. This scoping review aimed to characterize the intergenerational research on the associations between parental adverse and positive experiences across the life course (including childhood and adulthood) and the developmental, psychological and behavioral outcomes of their offspring. Following a search of ten databases, seven articles met the inclusion criteria. The majority of studies were cross-sectional (n = 4) and published in the United States (n = 6). Female caregivers dominated the data set (84.6%), with the large majority having a sample size above n = 1000. All studies reported a significant association between parent adversity and negative offspring outcomes; however, mixed findings were found for the protective properties of parents’ positive experiences. Findings indicate a need for further exploration, underscoring the importance of adequately powered studies inclusive and diverse in nature. Full article

Proactive mental health consultation–liaison (C-L) services in neonatal intensive care units (NICUs) are increasingly recognized as essential to infant health and family functioning, yet there is limited guidance on how to develop sustainable and effective programs in real-world clinical settings. This paper describes the development, implementation, and iterative refinement of a NICU mental health C-L program using a learning health system (LHS) framework. Grounded in a theory-driven model that conceptualizes the infant as the identified patient, the program was designed to target proximal mechanisms influencing infant regulation, parent–infant interaction, and medical course. Consistent with LHS principles, program elements were introduced incrementally and refined through embedded data collection, rapid feedback loops, and multidisciplinary team learning. Data sources emphasized feasibility, reach, implementation processes, and acceptability rather than hypothesis-driven outcome testing. Over six years, this approach supported the expansion of multiple integrated service components, including dyadic intervention services, parent mental health screening and referral pathways, unit-wide family engagement initiatives, and neurobehavioral care practices. Rather than presenting a fixed protocol, this paper offers a replicable framework for developing NICU mental health C-L services that balances developmental theory, implementation realities, and sustainability. The LHS approach provides a pragmatic roadmap for NICUs seeking to build or refine mental health services in contexts characterized by clinical complexity, evolving evidence, and system-level constraints. Full article

The family care of left-behind children often combines in-person grandparental caregiving with parental remote parenting; yet, how these two forms of care jointly relate to children’s mental health remains underexplored. Drawing on family systems theory, this study used data from 6317 rural left-behind children cared for by grandparents in the 2023 Hubei Province Survey of Vulnerable Children. Latent class analysis (LCA) and regression models were applied to identify grandparenting styles, parental remote parenting, and their interaction. Grandparenting styles were identified as warmly controlling, indifferent punitive, and mildly interventional. Compared with the mildly interventional style, the warmly controlling style was associated with higher resilience and lower psychological distress, whereas the indifferent punitive style showed the opposite pattern. Parental remote parenting was associated with higher resilience and lower psychological distress, but its strength varied across grandparenting contexts. In the indifferent punitive style, its positive association with resilience was weaker; in the warmly controlling style, its negative association with psychological distress was weaker. These findings suggest that parental remote parenting serves as a conditional family resource embedded in grandparental care environments, contributing to the mental health of left-behind children. The study shows the asymmetric role of intergenerational coparenting in psychological resilience and distress. Full article

Children whose primary caregivers experience mental illness and adverse psychosocial complexity are at increased risk of experiencing mental, physical, and relational challenges. Perinatal mental health services have commonly focused on treating the parental mental health problem; however, emerging evidence shows that parental mental health interventions alone are not sufficient to address the complex needs of both caregivers and their children. To address this gap in services, a new, highly specialised program—the Nurturing Connections Program—was implemented across three Australian local health districts within the State of New South Wales. The program is targeted to caregivers of young children referred to mental health services and aims to improve caregiver mental health and psychosocial adversity, child developmental outcomes, and the child–caregiver relationship. This study evaluated caregivers’ experiences with, and views of, the program. Twelve caregivers participated in semi-structured, in-depth interviews. A reflexive thematic analysis approach guided data interpretation. Four themes and three subthemes emerged from the data: (1) motivation for attending the program; (2) program components received; (3) post-program outcomes (subthemes: Caregiver-related outcomes, Child-related outcomes, and interpersonal outcomes); and (4) areas for program improvement. This study’s findings highlight program benefits, program facilitators and areas for improvement. Full article

Background: Adolescent substance abuse is a growing public health concern associated with poor mental health, unsafe sexual behaviour, violence, school dropout, and psychosocial dysfunction. In rural South Africa, peer influence, cultural practices, poverty, and inadequate psychosocial support may increase learners’ vulnerability to substance use. However, limited qualitative evidence exists on how these factors influence substance abuse among school learners in rural communities. Aim: This study explored peer-group and cultural influences on substance abuse among school learners in a rural community in Limpopo Province, South Africa. Methods: A qualitative, exploratory, descriptive, and contextual design was adopted. Purposive sampling was used to recruit 30 learners from selected secondary schools in the DIMAMO area of the Capricorn District, Limpopo Province. Data were collected through semi-structured one-on-one interviews until data saturation was reached. Interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis guided by Social Learning Theory. Trustworthiness was ensured through credibility, dependability, confirmability, and transferability. Ethical approval and informed consent were obtained prior to data collection. Results: Two major themes emerged: causes of substance abuse and factors maintaining substance use. Peer pressure and social influence contributed to the initiation of alcohol, cannabis, cigarette, and snuff use. Cultural practices and ancestral beliefs further normalised substance use behaviours. Psychological distress associated with poverty, family conflict, and inadequate parental support increased learners’ vulnerability. Continued substance use was reinforced by addiction, perceived emotional relief, social tolerance, and easy access to substances. Conclusions: Adolescent substance abuse in rural communities is influenced by interconnected social, cultural, psychological, and environmental factors. Integrated school- and community-based psychosocial interventions are needed to strengthen adolescent mental health and substance abuse prevention strategies. Full article

Background: Canada’s Prairie Provinces have become a focal point for contentious educational policy debates. Saskatchewan’s Bill 137 (2023) and Alberta’s Education Amendment Act, 2024 (Bill 27) enacted sweeping restrictions on sexual health education and 2SLGBTQ+ student identity recognition, framed as ‘parental rights’. Manitoba maintains a rights-affirming, inclusive framework grounded in the Public Schools Act. This policy divergence has direct implications for students’ mental health, sexual health literacy, and equity. We conducted a systematic document search of official government websites of three Prairie Provinces (Alberta, Saskatchewan, Manitoba) and four major school boards, selected by size and demographic diversity: the Calgary Board of Education (CBE), Edmonton Public Schools (EPSB), Regina Public Schools (RPS), and the Winnipeg School Division (WSD). Searches were conducted in May 2026. The Intersectionality-Based Policy Analysis (IBPA) framework guided structured content analysis across three categories: (1) 2SLGBTQ+ recognition and affirming policy; (2) sexual health accessibility provisions; and (3) culturally responsive and EDI-consistent care. Documents were coded as ‘Yes’, ‘No’, or ‘Not Reported’ for each sub-category. The search yielded 56 documents; 34 met the inclusion criteria (20 provincial, 16 school board). The Alberta (n = 5) and Saskatchewan (n = 6) provincial documents were dominated by restrictive legislation: Bill 27 shifts sexual health education to an opt-in model, with ministerial vetting of all SOGI materials; Bill 137 bans third-party sexual health educators entirely and mandates parental consent for pronoun use, pre-emptively invoking the notwithstanding clause. Manitoba’s nine provincial documents (n = 8) reflect an affirmative legislative framework: 100% explicitly affirm 2SLGBTQ+ students, 100% cite human rights frameworks, and 78% maintain community health partnerships. At the school board level, EDI-consistent provisions were the strongest in the EPSB (n = 5) and WSD (n = 4), which have standalone SOGIE policies and active equity frameworks. The CBE (n = 3) retains affirming guidelines while implementing provincial opt-in requirements. The RPS (n = 3) maintains AP 353 on Gender and Sexual Diversity. Only two provincial documents (11%), both from Manitoba, explicitly referenced sexual health community partnerships; zero Alberta or Saskatchewan provincial documents did so post-2023. The structural divergence between provinces is stark. The Alberta and Saskatchewan policies render 2SLGBTQ+ students structurally vulnerable through opt-in exclusion, compel parental disclosure, and eliminate community health expertise from classrooms. Manitoba’s model demonstrates that EDI-consistent, rights-affirming sexual health policy is legislatively achievable. Urgent systemic reform is required to restore affirming care, reinstate community partnerships, and reverse opt-in models that deny students access to evidence-based sexual health education. Full article

The healthy development of executive function (EF) skills in childhood and adolescence provides a crucial foundation for later outcomes, from mental and physical health to academic achievement and socio-emotional functioning. Although meta-analyses have identified associations between children’s EF skills and early experiential factors, these are often examined in terms of broad categories (e.g., socioeconomic status) or cumulative risk factors (e.g., adverse childhood experiences; ACEs). The current study leverages longitudinal data (N = 1295) from six cohorts from the Environmental influences on Child Health Outcomes (ECHO) program to identify unique associations among specific prenatal, perinatal, and early life conditions and three specific EF skills (inhibitory control, working memory, and cognitive flexibility) measured later in childhood. Indicators of socioeconomic status, birth outcomes, parental characteristics, and pre- and post-natal exposures to alcohol and tobacco were measured before age 6 years. EF skills and language were measured from ages 6–15 years (M = 9.95, SD = 1.92), using measures from the NIH Toolbox. Two complementary statistical methods, a psychological network approach and regression trees, were employed to disaggregate early predictors of EF development. Results from both methods converged to suggest that specific early conditions showed associations with specific EF skills, and that higher birth weight (independent of pre-term status) was a stronger predictor of better EF skills than other early conditions. Neither approach showed meaningful associations between EF skills and maternal ACEs. Birth weight appears to serve as a particularly sensitive summary index of prenatal influences on EF development. Full article

Though perinatal mental health has been frequently examined in the context of maternal depression, research has minimally explored the degree to which a partner’s perinatal mental diagnosis influences perinatal mood and anxiety disorder incidence. Drawing on Bowen’s Family Systems Theory, we examine co-occurring symptoms of postpartum depression and anxiety (PPD/A) and support dynamics within couples through a cross-sectional mixed-methods study. In the summer of 2024, birthing and non-birthing caregivers (n = 907) across the United States completed a survey including a modified Edinburgh Postnatal Depression Scale (EPDS) and additional questions about partner support, screening, and communication. Post-survey interviews (n = 17) revealed further insight into the relational dynamics of co-occurring PPD/A symptoms among couples. Survey analyses indicated correlations between birthing and non-birthing partner experiences of PPD/A. Further, co-occurrence was associated with diminished emotional support and increased distress for birthing parents. Participants who desired more partner support or felt afraid to express their feelings had significantly higher EPDS scores. Qualitative findings reinforced these patterns, highlighting the roles of relational strain, gender norms, and lack of systemic support for perinatal mental health. Findings suggest couple-based screening practices and interventions that recognize the bidirectional emotional impact of PPD/A may hold promise for improving outcomes across the entire family system. Full article