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Background: Help-seeking is intrinsic to efforts to manage the onset, maintenance, or escalation of mental health difficulties during adolescence. However, our understanding of adolescent help-seeking remains somewhat nebulous. A greater comprehension of help-seeking behaviour from the perspective of adolescents is needed. It is also prudent to explore help-seeking behaviour in the context of perceived cause for emotional distress, particularly as causal beliefs have been found to influence help-seeking behaviour in adults. Objectives: The present study sought to categorise adolescents’ experiences of help-seeking, and to examine the extent to which these categories (or ‘types’) of help-seeking behaviour are associated with their perceptions of causal factors for emotional distress. Methods: The data for this study were drawn from interviews conducted as part of the HeadStart Learning Programme. The sample comprised of 32 young people aged 11–12 years. Ideal type analysis, a qualitative form of person-centred analysis, was used to construct a typology of adolescent help-seeking. Participants help-seeking ‘type’ was then compared with their perceived cause for emotional distress ‘type’. Findings: We developed four distinct categories of help-seeking: 1) guided by others who have taken notice; 2) sceptical with unmet needs; 3) motivated and solution focused; and 4) preference for self-regulation. Simultaneously, we identified principal associations between perceived cause of emotional distress, as identified in an earlier paper, and help-seeking approaches. Conclusions: This study demonstrates meaningful and distinct categories of adolescent help-seeking and offers empirical evidence to support the assertion that perceived cause for emotional distress influences the help-seeking approaches of adolescents.

Background Identifying adolescents at risk of internalizing problems is a key priority. However, studies have tended to consider such problems in simple ways using diagnoses, or item summaries. Network theory and methods instead allow for more complex interaction between symptoms. Two key hypotheses predict differences in global network properties for those at risk: altered structure and increased connectivity. Methods The current study evaluated these hypotheses for nine risk factors (e.g., income deprivation and low parent/carer support) individually and cumulatively in a large sample of 12-15 year-olds (N = 34,564). Recursive partitioning and bootstrapped networks were used to evaluate structural and connectivity differences. Results The pattern of network interactions was shown to be significantly different via recursive partitioning for all comparisons across risk-present/absent groups and levels of cumulative risk, except for income deprivation. However, the magnitude of differences appeared small. Most individual risk factors also showed relatively small effects for connectivity. Exceptions were noted for gender and sexual minority risk groups, as well as low parent/carer support, where larger effects were evident. A strong linear trend was observed between increasing cumulative risk exposure and connectivity. Conclusions A robust approach to considering the effect of risk exposure on global network properties was demonstrated. Results are consistent with the ideas that pathological states are associated with higher connectivity, and that the number of risks, regardless of their nature, is important. Gender/sexual minority status and low parent/carer support had the biggest individual impacts on connectivity, suggesting these are particularly important for identification and prevention.

Objective: Adolescent wellbeing is a key research and policy priority, but little is known about neighbourhood-level influences. This study examined the extent to which adolescents’ life satisfaction and internalising symptoms vary between neighbourhoods, and which neighbourhood characteristics are associated with individual outcomes.Method: Baseline data from the #BeeWell cohort study in Greater Manchester (England) including 35,902 adolescents (aged 12-15) across 243 neighbourhoods were linked to neighbourhood characteristics (e.g. access to education and health services, leisure facilities) from the Co-op’s Community Wellbeing Index and analysed using multilevel regression.Results: Neighbourhoods explained 0.61% and 1.17% of the variation in life satisfaction and internalising symptoms, respectively. Socio-demographic inequalities in these outcomes varied across neighbourhoods. Several neighbourhood characteristics were associated with wellbeing, but differences across model specifications were observed (e.g., adjusted vs unadjusted; unique associations vs grouped domains). However, higher levels of perceived wellbeing support from local people were associated with lower internalising symptoms in all models. Other characteristics associated with better wellbeing outcomes in various models included lower GP antidepressant prescription rates, and better access to health services, areas for leisure, and good places to spend free time.Conclusion: Neighbourhoods account for a small but significant proportion of the variance in adolescent life satisfaction and internalising symptoms. Some neighbourhood characteristics (notably neighbourhood social capital) are associated with these outcomes at the individual level, and disparities in these outcomes for some groups vary across neighbourhoods. Our findings speak to the role of place as a determinant of adolescent wellbeing, with consequent implications for intervention.

Background: Gender and sexual minority adolescents experience greater symptoms of distress than their peers, but little is known about broader aspects of their wellbeing. Method: 37,978 adolescents (aged 12-15, attending 165 secondary schools) completed surveys reflecting hedonic, eudaimonic, and complete state frameworks of wellbeing. Structural correlated factors models were used to assess gender identity and sexual orientation wellbeing inequalities.Results: Wellbeing inequalities among gender and sexual minority respondents were routinely substantially greater than those concerning other characteristics (e.g., socio-economic disadvantage). Non-binary and gay/lesbian or bi/pansexual adolescents were subject to the most substantial disparities. Variation was evident across wellbeing domains, with (for example) substantially greater disparities in symptoms of distress than mental wellbeing for females, bisexual, and gay/lesbian young people in the complete state model. Conclusions: Improved monitoring and prevention efforts, combined with services that can better identify and meet the wellbeing needs of LGBTQ+ youth (e.g., access to high quality gender affirmative care), are urgently needed.

BackgroundAdolescent mental health is a major concern and brief general self-report measures can facilitate insight into intervention response and epidemiology via large samples. However, measures’ relative content and psychometrics are unclear.MethodA systematic search of systematic reviews was conducted to identify relevant measures. We searched PsycINFO, MEDLINE, EMBASE, COSMIN, Web of Science, and Google Scholar. Theoretical domains were described, and item content was coded and analysed, including via the Jaccard index to determine measure similarity. Psychometric properties were extracted and rated using the COSMIN system. ResultsWe identified 22 measures from 19 reviews, which considered general mental health (positive and negative aspects together), life satisfaction, quality of life (mental health subscales only), symptoms, and wellbeing. Measures were often classified inconsistently within domains at the review level. Only 25 unique indicators were found and several indicators were found across the majority of measures and domains. Most measure pairs had low Jaccard indexes, but 6.06% of measure pairs had >50% similarity (most across two domains). Measures consistently tapped mostly emotional content but tended to show thematic heterogeneity (included more than one of emotional, cognitive, behavioural, physical and social themes). Psychometric quality was generally low. ConclusionsBrief adolescent general mental health measures have not been developed to sufficient standards, likely limiting robust inferences. Researchers and practitioners should attend carefully to specific items included, particularly when deploying multiple measures. Key considerations, more promising measures, and future directions are highlighted. Keywords: adolescence, measurement, mental health

Internalizing symptoms are the most prevalent mental health problem in adolescents, with sharp increases seen, particularly for girls, and evidence that young people today report more problems than previous generations. It is therefore critical to measure and monitor these states on a large scale and consider correlates. We used novel panel network methodology to explore relationships between internalizing symptoms, well-being, and inter/intrapersonal indicators. A multiverse design was used with 32 conditions to consider the stability of results across arbitrary researcher decisions in a large community sample over three years (N = 15,843, aged 11–12 at Time 1). Networks were consistently similar for girls and boys. Stable trait-like effects within anxiety, attentional, and social indicators were found. Within-person networks were densely connected and suggested mental health and inter/intrapersonal correlates related to one another in similar complex ways. The multiverse design suggested the particular operationalization of items can substantially influence conclusions. Nevertheless, indicators such as thinking clearly, unhappiness, dealing with stress, and worry showed more consistent centrality, suggesting these indicators may play particularly important roles in the development of mental health in adolescence.

Dual-factor models of mental health have emphasized the importance of considering both mental health difficulties and wellbeing in young people. However, studies to date have failed to consider the conceptual and statistical similarity between wellbeing and internalizing indicators. Drawing on network methods, we present exploratory and confirmatory models of indicator-level interactions for internalizing symptoms and wellbeing in two large independent samples (sample 1, N = 14,805, sample 2, N = 14,066). A densely connected network was found which showed good stability across samples. The most and strongest relationships were observed within the two domains. Nevertheless, direct associations similar to some within-domain relationships were also observed between internalizing and wellbeing indicators. Worry was the most central indicator in both samples, and was meaningfully related to the wellbeing indicator “feeling relaxed”. Evidence of known-groups validity was demonstrated since indicator-level interactions in the networks were sensitive to known differences between girls and boys. Findings suggest the covariance between internalizing symptom and wellbeing indicators in adolescent datasets should be more closely attended to, and controlled for in intervention and epidemiological research.Key words: internalizing symptoms, wellbeing, adolescence, network analysis