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Background: Unmet pediatric mental health (MH) needs are growing as rates of pediatric depression and anxiety dramatically increase. Access to care is limited by multiple factors, including a shortage of clinicians trained in developmentally specific, evidence-based services. Novel approaches to MH care delivery, including technology-leveraged and readily accessible options, need to be evaluated in service of expanding evidence-based services to youths and their families. Preliminary evidence supports the use of Woebot, a relational agent that digitally delivers guided cognitive behavioral therapy (CBT) through a mobile app, for adults with MH concerns. However, no studies have evaluated the feasibility and acceptability of such app-delivered relational agents specifically for adolescents with depression and/or anxiety within an outpatient MH clinic, nor compared them to other MH support services. Objective: This paper describes the protocol for a randomized controlled trial evaluating the feasibility and acceptability of an investigational device, Woebot for Adolescents (W-GenZD), within an outpatient MH clinic for youths presenting with depression and/or anxiety. The study's secondary aim will compare the clinical outcomes of self-reported depressive symptoms with W-GenZD and a telehealth-delivered CBT-based skills group (CBT-group). Tertiary aims will evaluate additional clinical outcomes and therapeutic alliance between adolescents in W-GenZD and the CBT-group. Methods: Participants include youths aged 13-17 years with depression and/or anxiety seeking care from an outpatient MH clinic at a children's hospital. Eligible youths will have no recent safety concerns or complex comorbid clinical diagnoses; have no concurrent individual therapy; and, if on medications, are on stable doses, based on clinical screening and as well as study-specific criteria. Results: Recruitment began in May 2022. As of December 8, 2022, we have randomized 133 participants. Conclusions: Establishing the feasibility and acceptability of W-GenZD within an outpatient MH clinical setting will add to the field's current understanding of the utility and implementation considerations of this MH care service modality. The study will also evaluate the noninferiority of W-GenZD against the CBT-group. Findings may also have implications for patients, families, and providers looking for additional MH support options for adolescents seeking help for their depression and/or anxiety. Such options expand the menu of supports for youths with lower-intensity needs as well as possibly reduce waitlists and optimize clinician deployment toward more severe cases. [ABSTRACT FROM AUTHOR]

There are many contradictions in previous studies of the status of depressive symptoms among Chinese migrant children, the number of which in the compulsory education stage is about 13.9 million. This systematic review and meta-analysis were designed to compare depressive symptoms among migrant children and their urban children. Around 2,710 papers were retrieved from PubMed, OVID, the Web of Knowledge, CNKI, Wan Fang, Chongqing VIP, and Chinese Social Sciences Citation Index on January 27, 2020. Thirty-Two studies met study criteria with 14,906 migrant children and 10,792 urban children. Migrant children scored significantly higher for depressive symptoms score (SMD = 0.307, 95% CI [0.222, 0.393]). Region significantly influenced the difference of depressive symptoms between migrant children and urban children. Large effect sizes came from studies using scales that focus on depressive mood while studies using scales that focus on depressive behavioural symptoms had small effect sizes. Future research should focus on treatments to decrease depressive mood of migrant children. Future studies can add information about the length of their current stay in the urban location to improve the quality of study. PROSPERO registry: Systematic review registration no. CRD42018090676. [ABSTRACT FROM AUTHOR]

Children and adolescents are at a significantly high risk of mental health problems during their lifetime, among which are depression and anxiety, which are the most common. Life skills education is one of the intervention programmes designed to improve mental wellbeing and strengthen their ability to cope with the daily stresses of life. This review aimed to identify and evaluate the effect of life skills intervention on the reduction of depression, anxiety and stress among children and adolescents. Following the Population, Intervention, Comparison and Outcome (PICO) model and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2009 checklist, eight databases (Academic Search Complete, CINAHL, Cochrane, MEDLINE, Psychology and Behavioural Sciences Collection, PubMed, Scopus and Web of Science) were systematically reviewed from 2012 to 2020. The search was limited to English papers only. It included published experimental and quasi-experimental studies addressing the effect of life skills interventions on the reduction of at least one of the following mental health disorders: depression, anxiety and stress among children and adolescents (from the age of 5 years old to 18 years old). We used the Joanna Briggs Institute checklist for experimental and quasi-experimental studies to evaluate the quality of the included studies. This study was registered in PROSPERO [CRD42021256603]. The search identified only 10 studies (three experimental and seven quasi-experimental) from 2,160 articles. The number of the participants was 6,714 aged between 10 years old and 19 years old. Three studies in this review focused on depression and anxiety, whereas one study investigated depression and the other anxiety. Three studies targeted only stress and two examined the three outcomes, namely, depression, anxiety and stress. Almost in all studies, the life skills intervention positively impacted mental disorders, considering the differences among males and females. The overall methodological quality of the findings was deemed to be moderate to high. Our results clearly indicated the advantages of life skills programmes among adolescents in different settings and contexts. Nonetheless, the results highlight some important policy implications by emphasising the crucial roles of developers and policymakers in the implementation of appropriate modules and activities. Further research examining life skills intervention with a cultural, gender perspective, age-appropriate and long-term effect is recommended. [ABSTRACT FROM AUTHOR]

Many adolescents in South Korea experience risk-level depressive symptoms due to stress caused by personal and environmental changes. Prior studies investigated various characteristics of depressive symptoms. However, it is unclear when the mean level of depression changes with the development of children and adolescents and whether it is stable relative to one another over time. Thus, it is necessary to closely understand the continuity and stability of depressive symptoms across developmental stages in children and adolescents. In this study, continuity refers to the consistency in a group's mean level of depressive symptoms over time; however, stability refers to the consistency in the relative placement of the levels of depressive symptoms of individuals within a group over time. To comprehensively understand previous studies, this meta-analysis compiled data from 95 South Korean longitudinal studies (N = 200,338; 49.7% females) published between 2000 and 2021. Data were analyzed using a three-level random effects model with a 1-year interval for each age group to integrate effect sizes, followed by a generalized additive mixed model integrating age as a continuous variable. The results indicate that the mean-level continuity of depressive symptoms was relatively high and the rank-order stability was low for the children in elementary school (including both upper and lower grades). Additionally, as the adolescents aged, the mean-level continuity of depressive symptoms slightly decreased while stability increased. When entering early adulthood, the continuity and stability of depressive symptoms converged without significant change. As a result of moderating effect, the female-only group indicated a high level of continuity and stability than the male-only or mixed group. The findings highlight that South Korean childhood is a period of relatively high continuity and low stability. Moreover, female students' depressive symptoms fluctuate more than those of males, suggesting the need for providing effective and appropriate help. [ABSTRACT FROM AUTHOR]

The study investigated Peer Victimisation and Mental Health of Primary School Pupils. Respondents comprised 235 primary school pupils selected from nine primary schools across three Local Government Areas in Ekiti State, Nigeria. The participants were between 6 and 11 years and were stratified into lower and upper primary classes. The Multidimensional Peer-Victimisation Scale, Children's Depression Inventory-Short, and Multidimensional Anxiety Scale for Children were used to elicit information for the study. The results indicated that respondents reported largely high levels of peer victimisation with verbal victimisation as the most common form of peer victimisation. There were significant differences between male and female respondents on verbal and social forms of peer victimisation. Also, the study established that feeling unhappy and nervousness were forms of depression and anxiety experienced as a result of peer victimisation. The study brings into attention the need to encourage a consistent checking of victimisation rates and identify pupils that are at risk. [ABSTRACT FROM AUTHOR]

Migration‐related stress is detrimental to children's mental health, yet little is known about the potential mechanisms behind this association. This study examines the mediating role of inflow city identity in the association between migration‐related stress and depression and the moderating role of social participation amongst Chinese migrant children. A sample of 484 migrant children aged 8–17 years is randomly recruited through a cross‐sectional survey in Kunming, China. Inflow city identity partially mediates the association between migration‐related stress and migrant children's depression. Moreover, social participation moderates the above relationship. The direct and indirect effects are significant for migrant children with low social participation but insignificant for migrant children with high social participation. This study deepens the theoretical understanding of the underlying mechanism between migration stress and psychological distress and provides practical implications for preventing mental disorders in Chinese migrant children. [ABSTRACT FROM AUTHOR]

Past studies have indicated that mothers who are victims of intimate partner violence (IPV) have a greater risk of developing depression symptoms. Furthermore, existing literature provides evidence that children's mental health can be affected by their mother's mental health well past infancy and early childhood. Given this, children of IPV victims are particularly at risk of developing depression symptoms. Guided by trauma theory, the ecobiodevelopmental (EBD) framework, and social learning theory, this study investigates the long-term relationship between maternal IPV victimization during pregnancy and teen depression symptoms. This study utilizes longitudinal data from the Fragile Families and Child Wellbeing Study to examine the relationship between IPV during pregnancy and maternal depression symptoms at early childhood, as well as the mechanism by which maternal depression symptoms affect child depression symptoms in the adolescent stage of development. The findings indicate that mothers who were victims of IPV during pregnancy were more likely to have depression symptoms when children turned 3 and that maternal depression symptoms could directly predict children's depression symptoms at age 15. Meanwhile, maternal depression symptoms could indirectly increase adolescent depression symptoms via physical punishment at age 5 and bullying victimization at age 9. While extensive evidence has shown that IPV during pregnancy has detrimental effects on mothers and children, our study adds to the literature that such detriments can last as long as a decade. Given that depression symptoms can be detrimental to later development, the findings call for universal and comprehensive IPV screening tools and swift service referrals for pregnant women who are experiencing IPV. At the same time, trauma-informed parenting education for women, along with school- and community-based interventions for children, may also mitigate these harmful associations. [ABSTRACT FROM AUTHOR]

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The Teachers Acceptance and Action Questionnaire (TAAQ) was designed to assess teachers' experiential avoidance (EA) related to their professional context. The current study aimed to adapt the TAAQ for European Portuguese (TAAQ-PT) and address its factor structure and psychometric characteristics. EA is defined as an emotion regulation process encompassing the unwillingness to stay in touch with negative private events and deliberate efforts to control them. EA has been pointed out as a transdiagnostic process associated with a wide range of psychological difficulties, playing a pivotal role in their development and maintenance (e.g., depression and anxiety). A sample of 304 Portuguese teachers completed the TAAQ-PT, the Depression Anxiety and Stress Scales-21 (DASS-21), the Utrecht Work Engagement Scale (UWES), and the Five Facet Mindfulness Questionnaire (FFMQ). The TAAQ-PT one-factor structure was tested through confirmatory factor analysis and revealed a good fit to the data and excellent internal consistency. The TAAQ-PT showed significant positive correlations with depression, anxiety and stress symptoms and negative correlations with mindfulness and work engagement. Overall, the TAAQ-PT revealed to be a short, valid and reliable measure of teachers' EA. [ABSTRACT FROM AUTHOR]

Research indicates both natural mentoring and family factors such as parental support are beneficial for the psychological wellbeing of youth. Despite the existing evidence on the benefits of natural mentoring and parental support, there has been little evidence that considers the simultaneous influence of these factors on the depressive symptoms among Black youth. Guided by Keller's systemic model of mentoring, we investigated the influence of mother support and the characteristics of natural mentoring relationships on depressive symptoms among Black youth. We used nationally representative data of Black youth from the National Longitudinal Study of Adolescent Health (N = 2344). The findings indicate that both mentor bonding and mother support were significant predictors of depressive symptoms among Black youth. However, mother support was positively associated with depressive symptoms and mentor bonding was negatively associated with depressive symptoms. The findings highlight the importance of natural mentors in the lives of Black youth and suggest they may be useful in alleviating depressive symptoms. Highlights: Investigated the influence of mother support and natural mentoring relationships on depressive symptoms among Black youth. Both natural mentoring and mother support were significant predictors of depressive symptoms among Black youth, surprisingly mother support was positively associated with depressive symptoms for Black youth. Findings highlight the importance of a close relationship between natural mentors in alleviating depressive symptoms for Black youth. The association between natural mentoring and depressive symptoms varied by the mentor's gender. Positive perceived general health does not always equate to positive psychological health for Black youth. [ABSTRACT FROM AUTHOR]

There remains a need for a disorder-specific inventory of children's depression and anxiety that can reliably screen anxious and depressive disorder symptomatology in Chinese children. The Revised Child and Anxiety Depression Scale (RCADS) is a self-report questionnaire assessing anxiety and depression in children (Chorpita et al., 2000; Piqueras et al., 2017). This study sought to evaluate its psychometric properties in a Mainland Chinese sample. Students from the 4th to 11th grades (N = 1001) participated in this study. Each of the RCADS subscales, by age and sex, possessed reliability coefficients ranging between.63 and.81. Means and standard deviations for RCADS subscales calculated for the age and sex sub-samples were reported. Participants reported slightly lower levels on five subscales than for Chorpita et al. (2000) normative sample. The scales were significantly and strongly correlated with the Child Behavior Checklist (CBCL) subscales (somatic, withdrawal, anxiety) as well as CBCL internalizing scores. Fit statistics suggested marginal to adequate fit for the six-factor model for the Chinese youth. The present study provides foundational support for the psychometric properties of the RCADS in a large sample of Chinese youth yet indicates that factor structure might be improved through enhanced sampling of culturally relevant symptom expressions. [ABSTRACT FROM AUTHOR]

As pediatric depression becomes more prevalent around the world, establishing which treatments are efficacious for managing depression has become imperative. This review presents a summary of the literature on the efficacy of cognitive behavioural therapy (CBT) and fluoxetine as standalone treatments, and in combination to determine the most efficacious treatment for pediatric depression. The literature on the efficacy of CBT as a treatment for depression in youth has shown inconsistent and mixed results in terms of response rates and symptoms reduction. Moreover, fluoxetine treatment for pediatric depression has displayed more positive results than what has been shown by CBT alone, however the results for these analyses must also be interpreted with caution. To continue, much of the literature reviewed concerning the use of CBT and fluoxetine as standalone treatments possess several limitations that question the validity of the efficacy of these treatments. The limitations include a small number of trials used in the reviews, biases in the individual studies, selective reporting of results, and differing participant characteristics across studies. Further research on the efficacy of CBT and fluoxetine separately is needed to conclude that they are efficacious treatments for pediatric depression. Overall, the literature examining the efficacy of CBT and fluoxetine in combination for the treatment of pediatric depression has displayed consistent positive results, with much of the literature suggesting that the combination of treatments is more efficacious than either treatment alone. [ABSTRACT FROM AUTHOR]

Using 318 household data concerning children during middle childhood (8–13), we examined the association among each parent's marital satisfaction, the child's perceived family functioning, and the child's anxiety and depression. Second, we investigated whether the other parent could buffer or facilitate this chain effect by co-viewing programs via various devices with their child so as to improve the child's perceived family functioning. Results verified the mediation effect that maternal marital satisfaction was positively associated with the child's perceived family functioning, which, in turn, decreased the child's depression. In addition, the results indicated that increased paternal co-viewing enhanced the positive association between maternal marital satisfaction and the child's perceived family functioning and then decreased the child's depression. The theoretical and practical implications are discussed within the framework of family systems theory, parental media interventions, and the different roles of the father and mother in family functionality. [ABSTRACT FROM AUTHOR]