Increased levels of psychological stress during adolescence have been associated with a decline in academic performance, school dropout and increased risk of mental health problems. Intervening during this developmental period may prevent these problems. The school environment seems particularly suitable for interventions and over the past decade, various school-based stress reduction programs have been developed. The present study aims to evaluate the results of (quasi-)experimental studies on the effectiveness of school-based intervention programs targeting adolescent psychological stress and to investigate moderators of effectiveness. A three-level random effects meta-analytic model was conducted. The search resulted in the inclusion of k = 54 studies, reporting on analyses in 61 independent samples, yielding 123 effect sizes (N = 16,475 individuals). The results indicated a moderate overall effect on psychological stress. Yet, significant effects were only found in selected student samples. School-based intervention programs targeting selected adolescents have the potential to reduce psychological stress. Recommendations for practice, policy and future research are discussed.
Parental support, stimulation, positive discipline, and structure are all important for social-emotional adjustment of toddlers and preschoolers. However, less is known about the relative importance of these positive parenting practices. The current crosssectional study examines the associations between positive parenting practices and child social-emotional difficulties in relation to child age and parental gender. Design. 446 Dutch families (446 mothers, M age = 33.51 years; 446 fathers, M age = 35.63 years) rearing a child (46.9% boys) between 17 and 48 months of age (M age = 31.64) participated. Parents reported on their own positive parenting practices, and mothers reported on child externalizing and internalizing behaviors as an indication of social-emotional difficulties.Results. Increased support from both mothers and fathers, and maternal provision of structure are associated with lower levels of child externalizing and internalizing behaviors. Positive discipline from both mothers and fathers, however, is related to higher levels of child externalizing and internalizing behaviors, and stimulation from both mothers and fathers is unrelated to either. These associations are not moderated by child age and are similar for mothers and fathers, except maternal structure is linked to lower levels of child externalizing and internalizing behaviors, whereas paternal structure is unrelated to child social-emotional difficulties. Conclusions. The present study underscores the significance of investigating the effects of multiple positive parenting practices simultaneously and calls for involving both mothers and fathers in parenting programs.
Chronic stress is associated with dysregulations in the physiological stress system, resulting in diverse negative developmental outcomes. Since adolescence is a period characterized by increased stress‐sensitivity, and schools are an important environment for the developing adolescent, school‐based interventions promoting psychosocial functioning are of particular interest to prevent adverse outcomes. The present study therefore aimed to investigate the effectiveness of such interventions on hypothalamic pituitary adrenal‐axis (i.e., cortisol) and cardiovascular (i.e., blood pressure [BP] and heart rate [HR]/heart rate variability [HRV]) parameters of stress in adolescents, and examined moderators of effectiveness. The search resulted in the inclusion of k = 9 studies for cortisol, k = 16 studies for BP, and k = 20 studies for HR/HRV. The results indicated a significant small overall effect on reducing BP, but no significant effect for HR/HRV. For cortisol, large methodological variation in the few primary studies did not allow for quantitative analyses, but a qualitative review demonstrated inconsistent results. For BP and HR/HRV, larger effects were observed for intervention programs with a mindfulness and/or meditation component, for interventions without a cognitive‐behavioural component and for interventions with a higher intensity. Providing adolescents with techniques to improve indicators of physiological stress may prevent emerging mental health problems.
Depression is a major problem in youth mental health and identified as the leading cause of disability worldwide. There is ample research on the acute effects of treatment, with estimated small-to-moderate effect sizes. However, there is a lack of research on long-term outcomes. A total of 129 adolescents with clinical depression (82.2% female), aged 13–22 (M = 16.60, SD = 2.03), received blended CBT, face-to-face CBT or treatment as usual. Data were collected at 12 months after the intervention and compared between treatment conditions. Clinical diagnosis, depressive symptoms, suicide risk, internalizing symptoms and externalizing symptoms decreased significantly over time, from baseline to the 12-month follow-up, and also from post-treatment to the 12-month follow-up in all three conditions. Changes were not significantly different between conditions. At the long-term, improvements following the treatment continued. Due to the large amount of missing data and use of history control condition, our findings need to be interpreted with caution. However, we consider these findings as a clinical imperative. More evidence might contribute to convincing adolescents to start with therapy, knowing it has lasting effects. Further, especially for adolescents for whom it is not possible to receive face-to-face treatment, blended treatment might be a valuable alternative. Our findings might contribute to the implementation of blended CBT.
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