Conference Agenda

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Session Overview
Session
T902: THEMATIC SESSION: Internalizing and Externalizing Symptoms in Childhood and Adolescence: Mechanisms and Moderators
Time:
Friday, 29/Aug/2025:
9:00am - 10:30am

Session Chair: Per Helge H. Larsen
Location: BETA 1


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Presentations

Examining the Social Gradient in Offspring Mental Health: A Longitudinal Study of Socioeconomic Inequalities and Mediating Mechanisms

Per Helge H. Larsen, Vera Skalicka, Lars Wichstrøm

NTNU, Norway

Mental health problems in children and adolescents are disproportionately distributed along socioeconomic lines, creating a marked social gradient such that parental low socioeconomic position (SEP) is associated with more mental health problems in offspring. Yet the specific pathways through which parental SEP shapes the development of internalizing and externalizing symptoms in offspring —and whether these patterns reflect social causation or social selection—remain under-examined. This research project draws on community-based data from the Trondheim Early Secure Study (TESS), which has followed over 600 Norwegian children biennially from age 4 to 18. A major strength of TESS is its reliance on psychiatric interviews for assessing offspring mental health. We employ advanced longitudinal modeling, including random intercept cross-lagged panel models, to isolate within-person effects, while controlling for stable effects of unmeasured confounders across time, providing insights into potential contributing pathways.

In this presentation, we will describe preliminary findings on the extent to which SEP indicators—particularly parental education and occupational status—relate to youths’ internalizing and externalizing symptoms (as measured by the Child and Adolescent Psychiatric assessment [CAPA] and Kiddie Schedule for Affective disorders and Schizophrenia [K-SADS]) over time. We will also investigate whether familial and peer factors (e.g., interparental conflict measured by the Conflicts and Problem–Solving Scales and bullying victimization measured by the Revised Olweus Bully/Victim Questionnaire) mediate these associations, as previous research suggests they may transmit socioeconomic strain. This presentation will outline the conceptual framework, research design, and analytical strategy, and share preliminary findings on parental educational attainment and occupational status to illustrate the development of risk. I conclude by discussing implications of these preliminary results for future research on socioeconomic inequalities in youth mental health, with a focus on refining our understanding of mechanisms and identifying avenues for more targeted intervention efforts.



Do Risk Factors for Anxiety Problems change from Middle Childhood to Early-to-Late Adolescence?

İlayda Çalışkan Demirbaş1, Başak Şahin-Acar1, Aysun Doğan2, Deniz Tahiroğlu3, Sibel Kazak Berument1

1METU, Turkiye; 2Ege University, Turkiye; 3Boğaziçi University, Turkiye

The present study aimed to longitudinally examine the potential risk factors that may lead to anxiety problems in children at different developmental levels (i.e. middle-childhood, early adolescence, middle-late adolescence) and how those risk factors may change based on gender. For this aim, this study builds on Bronfenbrenner’s Ecological Systems Theory (1979), by considering both macrosystem (e.g., economic conditions, parental beliefs) and microsystem (e.g., parenting behaviors, temperament) factors in predicting anxiety. As part of nationwide project conducted in Türkiye, 3094 elementary, middle- and high-school children and their mothers were participated in the study at two time-points. Risk factors were assessed at Time-1 while anxiety was assessed at Time-2, after 1 year. Three hierarchical regression models were tested for school levels separately, and significant interactions were further analyzed with Process Macro (Hayes, 2018).

Results showed that, as contextual factors during middle-childhood, for both boys and girls, neighborhood stress and maternal depression, but only for girls, low maternal education and low SES were risk factors for anxiety.

During early adolescence, maternal anxiety and low maternal education were risk factors. Additionally, only for girls, marital conflict, mothers’ higher hierarchical relatedness and lower individual autonomy goals while for boys, low mothers’ hierarchical relatedness goals were also found as risk factors.

From middle-to-late adolescence, marital conflict for girls and maternal depression for boys appeared to be risk factors for anxiety problems.

Lastly, as child specific factors, at all developmental levels, being a girl, and temperamental characteristics of negative affect, overreaction to stimuli were identified as risk for anxiety, while lower depth of processing was a risk only for early adolescents.

In summary, the results implied that anxiety may be shaped through different processes during different developmental levels and these processes may also differ based on gender. Results will be discussed considering previous findings and potential implications.



Harnessing personal and social resources in managing internalising and externalising symptoms in children living in low-resource settings

Julia Michalek1, Kathryn Bates2, Jennifer Lau1

1Queen Mary University of London, United Kingdom; 2King's College London, United Kingdom

Children growing up in low-resource settings are at greater risk for lifelong psychiatric problems and mental ill health. They are both more likely to experience risk factors for developing early psychopathology and to be less likely to seek help and engage support for these problems. Resource-oriented therapeutic models – those that emphasise strengths of individuals and harness positive personal and social resources – may be particularly crucial in enriching socio-emotional development, and reducing the lifelong health inequalities that could arise amongst children growing up in socially-deprived areas.

In this pre-registered study, we used an exploratory, data-driven network model to investigate the use of personal (different emotion regulation strategies) and social (social connectedness, religion, recreational activities) resources of children living in East London (N = 867, Mage = 8.76 (0.95), 49% female) and their mental health outcomes using self- and teacher-reported questionnaires (data collected November 2022-2023).

We found that family, peer, and school connectedness were the most central elements of the network, while negative emotion regulation strategies seemed to be a part of the phenotype of anxiety and depression symptoms. Our findings highlight the importance of harnessing both internal strengths and positive social resources when thinking about intervention programmes for emotional symptoms in children growing up in deprived areas. Identifying strategies for nurturing social connectedness in children’s closest environment is also crucial to their development and resilience-building.



Externalizing Behavior Problems During Adolescence: An Ecological Perspective

Rana Durmuş1, Başak Şahin Acar1, Aysun Doğan2, Deniz Tahiroğlu3, Sibel Kazak Berument1

1Middle East Technical University, Turkiye; 2Ege University, Turkiye; 3Boğaziçi University, Turkiye

According to Ecological Theory, examining children's behaviors through both parental and environmental factors offers a more comprehensive understanding of underlying mechanisms. This study explores the relationships between contextual and environmental factors, mothers' physical and mental health, perceived maternal parenting practices, and adolescents' externalizing behaviors.

As part of a national project in Türkiye, 2066 mothers (Mage=39.83) and their children aged 10-18 (Mage=13.28, girls=1131) participated in the study. Data were collected at two time points, with all participants revisited one year later (Time 2). At Time 1, mothers reported economic hardship, neighborhood ecology, and their physical and mental health, while adolescents reported perceived positive (monitoring, warmth, inductive reasoning) and negative (psychological control, rejection, performance pressure) parenting behaviors. Adolescents' externalizing behaviors were reported by mothers at Time 2.

Path analysis was used to examine the mediating roles of maternal health and perceived parenting behaviors in the relationship between family-related socioeconomic and environmental factors and adolescents' externalizing problems. Separate analyses were conducted for positive and negative parenting behaviors.

Findings from structural equation models indicate that mothers' reported economic anxiety and hardship negatively affect their physical and psychological health. This, in turn, reduces positive parenting behaviors (behavioral control, warmth) while increasing negative parenting behaviors (psychological control, rejection), ultimately leading to higher externalizing problems in adolescents.

Additionally, better physical resources in the neighborhood were positively associated with maternal physical and psychological health, which in turn was linked to increased behavioral control and warmth, and decreased psychological control and rejection—leading to fewer externalizing problems in adolescents. While economic indicators had no direct effect on adolescents' externalizing problems, they indirectly influenced them through maternal health. The positive impact of neighborhood resources on both maternal well-being and positive parenting highlights the crucial role of children's living environments in shaping their behaviors.



The association between adolescent girls’ oral contraceptive use and depressive symptom development into young adulthood: The importance of adverse childhood experiences

Lotte Gerritsen, Stefanie A. Nelemans

Utrecht University, the Netherlands

Adolescence is a vulnerable period for the development of internalizing symptoms, with symptoms increasing to near-adult prevalence and pronounced sex differences emerging in this developmental period. Oral contraceptive (OC) use has been proposed as potential risk factor for the development of depressive symptoms among girls, but there appears to be large heterogeneity in the association between female OC use and depressive symptoms and empirical findings have been mixed. Therefore, this study aimed to gain a better understanding of the longitudinal association between adolescent girls’ OC use and the development of depressive symptoms across adolescence into young adulthood by focusing on the potential moderating role of adverse childhood experiences, or childhood trauma (i.e., experiences of abuse and/or neglect), in this association. Participants were 327 Dutch adolescents (Mage T1 = 13.01 years old, 43% female), who completed six annual and four biennial self-report questionnaires on depressive symptoms and OC use (only girls) from early adolescence into young adulthood. In addition, participants reported on the Childhood Trauma Questionnaire (CTQ) concerning experienced childhood trauma. As expected, preliminary results showed a strong main effect of childhood trauma on depressive symptoms, with higher levels of childhood trauma being associated with higher mean-levels of depressive symptoms across time (slightly stronger effect size for girls compared to boys). Importantly, childhood trauma significantly interacted with OC use to predict the development of depressive symptoms from adolescence into young adulthood: Girls reporting OC use and low childhood trauma showed similarly low levels of depressive symptoms across time as boys, whereas girls reporting OC use and high childhood trauma showed the highest levels of depressive symptoms across time. These results suggest that only for a specific subgroup of adolescent OC users there may be heightened risk for depressive symptoms across development. Findings are discussed from a neurobiological developmental perspective.