Classification of adults with problematic internet experiences: linking internet and conventional problems from a clinical perspective.

This article utilizes data from clinical reports of 929 adults to examine whether various problematic Internet experiences are distinctly different from or extensions of conventional problems. A TwoStep Cluster Analysis identified three mutually exclusive groups of adults, those with (1) online relationship problems and victimization; (2) online and offline problems; and (3) marital discord. Results suggest some initial support for the idea that problematic Internet experiences are often extensions of experiences and behaviors that pre-date the Internet. However, the Internet may be introducing some qualitatively new dimensions-such as an increased severity, an increased frequency, or unique dynamics-that require new responses or interventions.     

It’s my safe space: The life-saving role of the internet in the lives of transgender and gender diverse youth

Abstract

Background: Public awareness of Transgender and Gender Diverse (TGD) identities has grown significantly; however, acceptance and support remain elusive for many TGD youth. Resultant experiences of marginalization and stigmatization contribute to elevated rates of psychological distress and suicidality among TGD youth. Emergent evidence suggests that the internet may offer TGD youth safety, support, and community previously unavailable.

Aim: The primary aim of this qualitative inquiry is to engage in an in-depth exploration of the online experiences and processes which help protect against psychological distress and promote well-being among TGD youth.

Methods: Data were culled from a mixed-methods, online study of sexual and gender minority youth from across the United States and Canada which followed Institutional Review Board approved protocols. Participants for this study represent a sample (n?=?260) of TGD participants aged 14–22 (x? = 17.30). Data were analyzed using Charmaz’ grounded theory strategies.

Results: Data revealed that the internet offers TGD youth affirming spaces that, for the most part, do not exist in their offline lives. Online, TGD youth were able to engage meaningfully with others as their authentic selves, often for the first time. These experiences fostered well-being, healing, and growth through five processes: 1. Finding an escape from stigma and violence, 2. Experiencing belonging, 3. Building confidence, 4. Feeling hope, and 5. Giving back.

Discussion: The unique and innovative ways in which participants use online spaces to foster resilience offer important insights to inform affirmative practices with TGD young people.     

Developing an Online Early Detection System for School Attendance Problems: Results From a Research-Community Partnership

School refusal and other school attendance problems are vexing problems for school-aged youth, families, school personnel, and clinicians. However, few resources exist to detect problematic attendance. The current report describes three steps of a research-community partnership to develop an early identification program to detect youth at risk for problematic attendance. First, a survey was conducted to estimate the scope and cost of school refusal across grades K–12. School administrators estimated relatively few youth exhibiting significant school refusal (missing 5 or more days per year) but estimated the costs associated with services for these youth to be very high (mean cost of in-district programs: $94,052; mean cost of out-of-district placements: $496,657). Second, elementary school counselors were tasked with tracking absenteeism among at-risk youth using an online attendance tracking prototype. Counselors identified a high number of youth who showed elevated absences, lates, or early departures (17.2% of enrolled students), and counselor ratings were significantly related to whether the student (a) had received an individualized education plan or 504 plan, (b) had a sibling with similar attendance problems, (c) was older, or (d) had divorced or separated parents. In a final step, counselor feedback was sought and revisions were incorporated in the attendance tracker. Findings reinforce the prevalence and cost of school attendance problems, provide guidance for using technology to monitor attendance and related indices (tardies, early departures), and direct attention to youth factors that may be useful in identifying youth at risk for poor attendance.     

Non-binary and binary transgender youth: Comparison of mental health,self-harm,suicidality, substance use and victimization experiences

ABSTRACT

?Background: Little research has compared the mental health and victimization experiences of non-binary youth depending on their sex assigned at birth (SAAB), or compared these two groups with binary transgender youth.

Aims: To compare mental health, self-harm and suicidality, substance use and victimization experiences between non-binary and binary transgender young adults, both male assigned at birth (MAAB) and female assigned at birth (FAAB).

Methods: Online survey data from 677 participants from the “Youth Chances” community study of 16 to 25 year olds in the United Kingdom was analyzed, comparing across binary participants (transgender females (n = 105) and transgender males (n = 210)) and non-binary participants (MAAB (n = 93) and FAAB (n = 269)).

Results: Female SAAB participants (binary and non-binary) were more likely to report a current mental health condition and history of self-harm than male SAAB participants (binary and non-binary). Similarly, female SAAB participants (binary and non-binary) were more likely to report childhood sexual abuse than male SAAB participants (binary and non-binary); the reverse pattern was found for lifetime physical assault relating to being LGBTQ. Non-binary MAAB participants were less likely than the other groups to report past suicide attempts and previous help-seeking for depression/anxiety. Binary participants reported lower life satisfaction than non-binary participants. For all four groups, mental health problems, self-harm, suicidality, alcohol use and victimization experiences were generally higher than that of youth in general population studies.

Conclusions: These findings highlight the importance of considering both non-binary versus binary gender identity and SAAB in relation to mental health problems, self-harm, suicidality and substance use in transgender youth. The roles of sexual abuse, other abuse and discrimination in contributing to increased rates of mental illness and self-harm in non-binary and binary transgender individuals, particularly those who were assigned female at birth, relative to those assigned male, require investigation.     

Youth sports and physical activity: The relationship between perceptions of childhood sport experience and adult exercise behavior

ObjectiveParticipation in organized youth sports has been shown to positively correlate with increased levels of exercise in adulthood. However, there is limited research to suggest why youth sports participation is related to increased physical activity as an adult. One possible explanation is that positive youth sport experiences lead youth to be more positively inclined to engage in physical activity as adults. Research into the positive youth development aspect of organized sports provides the framework for the current investigation.MethodsAdult participants (N = 234, M_age = 35.35) were asked to retrospectively assess their youth sports experiences using the “Four C's” (i.e., competence, confidence, connectedness, character) framework of positive youth development in sport. These assessments were then compared to current physical activity levels and related variables found in the Health Action Process Approach model (HAPA; Schwarzer, 2008).ResultsBivariate correlations revealed statistically significant and moderate correlations among competence, confidence, and connectedness and all of the HAPA variables including physical activity levels. Further, a MANCOVA analysis revealed that when participants were sub-divided into “non-intenders,” “intenders,” and “actors” using a validated staging algorithm, a general linear trend emerged for competence, confidence, and connectedness such that “non-intenders” rated these constructs the lowest and “actors” rated them the highest.ConclusionThese findings provide preliminary evidence that the relationship between participation in organized youth sports and adulthood levels of exercise could be contingent on how positively that experience is perceived.     

Linkages between depressive symptomatology and Internet harassment among young regular Internet users.

Recent reports indicate 97% of youth are connected to the Internet. As more young people have access to online communication, it is integrally important to identify youth who may be more vulnerable to negative experiences. Based upon accounts of traditional bullying, youth with depressive symptomatology may be especially likely to be the target of Internet harassment. The current investigation will examine the cross-sectional relationship between depressive symptomatology and Internet harassment, as well as underlying factors that may help explain the observed association. Youth between the ages of 10 and 17 (N = 1,501) participated in a telephone survey about their Internet behaviors and experiences. Subjects were required to have used the Internet at least six times in the previous 6 months to ensure a minimum level of exposure. The caregiver self-identified as most knowledgeable about the young person's Internet behaviors was also interviewed. The odds of reporting an Internet harassment experience in the previous year were more than three times higher (OR: 3.38, CI: 1.78, 6.45) for youth who reported major depressive symptomatology compared to mild/absent symptomatology. When female and male respondents were assessed separately, the adjusted odds of reporting Internet harassment for males who also reported DSM IV symptoms of major depression were more than three times greater (OR: 3.64, CI: 1.16, 11.39) than for males who indicated mild or no symptoms of depression. No significant association was observed among otherwise similar females. Instead, the association was largely explained by differences in Internet usage characteristics and other psychosocial challenges. Internet harassment is an important public mental health issue affecting youth today. Among young, regular Internet users, those who report DSM IV-like depressive symptomatology are significantly more likely to also report being the target of Internet harassment. Future studies should focus on establishing the temporality of events, that is, whether young people report depressive symptoms in response to the negative Internet experience, or whether symptomatology confers risks for later negative online incidents. Based on these cross-sectional results, gender differences in the odds of reporting an unwanted Internet experience are suggested, and deserve special attention in future studies.     

No other choice: Speech-Language Pathologists’ attitudes toward using telepractice to administer the Lidcombe Program during a pandemic

PurposeTelepractice has been shown to be a viable modality for the delivery of stuttering treatment. Since the advent of COVID-19, speech-language pathologists must adapt in-clinic treatments for online presentation. This research aimed to gather information from speech-language pathologists on their experiences of telepractice to deliver the Lidcombe Program to treat stuttering in young children.MethodsThis paper presents the findings of an online survey that polled the clinical experiences of 106 speech-language pathologists who were delivering the Lidcombe Program via telepractice during COVID-19.ResultsThe majority of respondents were experienced clinicians from the United States and Canada who had attended a Lidcombe Program workshop. Prior to COVID-19, 80 % had provided some clinical services online (up to 10 % of the time), and at the start of COVID-19 public lockdown orders, 77 % viewed telepractice as both a necessity and an opportunity. Three months after the public lockdown orders, the large majority, 94 %, said that they would continue to use both telepractice and in-clinic treatment in the future. Technology issues, concerns about establishing the clinical relationship, and identification of mild stuttering featured as challenges of telepractice service delivery, while benefits included time efficiency, flexibility of scheduling, and improved clinical processes.ConclusionRespondents reported that the Lidcombe Program was easily translatable to telepractice and the majority intend to continue telepractice in the future.     

Non-binary youth: Access to gender-affirming primary health care

ABSTRACT

Background: Transgender (trans) youth who identify outside the gender binary are a growing subpopulation. In this article, we document differences in access to gender-affirming health care between binary and non-binary identified trans youth and explore ways of meeting the health needs of non-binary youth within primary care settings.

Methods: The Canadian Trans Youth Health Survey is a national online survey of trans youth, 14–25 years, conducted in 2013–2014. Among the 839 participants who responded to gender identity items in the survey, 41% identified as non-binary. We compared demographic, health outcome, and health care access responses between non-binary and binary (trans girls/women and trans boys/men) youth.

Results: Non-binary and binary youth were similar in most demographics, including age, geographic distribution, and ethnocultural backgrounds, however a larger proportion (82%) of non-binary youth were assigned female at birth. Older non-binary youth (aged 19–25) were significantly more likely to forego needed healthcare than older binary youth; no significant differences were found between younger (14–18) non-binary and binary youth in foregoing healthcare. Overall, non-binary youth (13%) were significantly less likely than binary youth (52%) to access hormone therapy, but they were more likely than binary youth to report experiencing barriers to accessing hormone therapy when needed.

Conclusions: Non-binary trans youth in Canada report challenges in accessing needed gender-affirming healthcare. Primary care providers are well-situated to integrate a broad range of gender-affirming care services into practice in order to address the unique needs of non-binary youth. Future research is warranted to explore experiences of non-binary youth related to barriers to care and to explore how services can be designed and delivered to better meet the needs of non-binary youth seeking gender-affirming primary care.     

Self-harm prevalence and ideation in a community sample of cis,trans and other youth

Abstract

Background: Trans youth have been reported to have high rates of self-harm, depression and bullying, and find it difficult to seek support. However, much of this research comes from gender identity clinics; non-clinical samples and those who reject gender binaries remain under-researched.

Aims: This study investigated the experiences of a community school-based sample of Trans, identifying youth, Other, and cis-gendered adolescents in relation to their experiences of low mood, bullying, associated support, self-harm ideation and peer-related self-harm.

Methods: An online survey was completed by 8440 13–17?year olds (3625 male, 4361 female, 227 Other, and 55 Trans).

Results: Trans and Other students had significantly higher rates of self-harm ideation and peer self-harm, in comparison to cis-gendered students. These Trans and Other students reported significantly higher rates of bullying and self-reported depression and significantly less support from teachers and staff at school, in fact these students did not know where to go to access help.

Discussion: This community sample confirms findings of high rates of self-harm ideation, self-reported depression and bullying for Trans youth as previously reported in clinic-based samples. However, by accessing a community sample, the salience of the category “Other” was established for young people today. While Other and Trans identified students both struggled to find support, those who identified as Trans were more likely to have been bullied, and have experienced self-reported depression and thoughts of self-harm. Thus, those who identify as transgender represent a high-risk group that needs targeted support within schools and by statutory and nonstatutory community services. Unpacking the category of Other would be beneficial for future research, as well as exploring resilience within this group and intersecting identities such as sexuality, Autism, or experiences such as earlier abuse.     

Exposure to internet pornography among children and adolescents: a national survey.

Estimates suggest that up to 90% or more youth between 12 and 18 years have access to the Internet. Concern has been raised that this increased accessibility may lead to a rise in pornography seeking among children and adolescents, with potentially serious ramifications for child and adolescent sexual development. Using data from the Youth Internet Safety Survey, a nationally representative, cross-sectional telephone survey of 1501 children and adolescents (ages 10-17 years), characteristics associated with self-reported pornography seeking behavior, both on the Internet and using traditional methods (e.g., magazines), are identified. Seekers of pornography, both online and offline, are significantly more likely to be male, with only 5% of self-identified seekers being female. The vast majority (87%) of youth who report looking for sexual images online are 14 years of age or older, when it is developmentally appropriate to be sexually curious. Children under the age of 14 who have intentionally looked at pornography are more likely to report traditional exposures, such as magazines or movies. Concerns about a large group of young children exposing themselves to pornography on the Internet may be overstated. Those who report intentional exposure to pornography, irrespective of source, are significantly more likely to cross-sectionally report delinquent behavior and substance use in the previous year. Further, online seekers versus offline seekers are more likely to report clinical features associated with depression and lower levels of emotional bonding with their caregiver. Results of the current investigation raise important questions for further inquiry. Findings from these cross-sectional data provide justification for longitudinal studies aimed at parsing out temporal sequencing of psychosocial experiences.     

Analysis of the indicators of pathological Internet use in Spanish university students

Addiction to and problematic use of the Internet are relatively recent phenomena whose scope, characteristics and correlates have begun to receive increasing attention by clinicians and researchers alike. The purpose of this study was to examine the relationship between time spent connected to the Internet and the variables that indicate a pathological and addictive use of this technological resource. The sample was comprised of 1,301 university students of both sexes (927 women and 374 men), with ages ranging from 18 to 30 years old. The results showed that, although most people use the Internet appropriately, users who invest higher quantities of time in the Internet more frequently exhibit connection behavior that is controlled through negative reinforcement, a high degree of arousal when online, loss of control over connection behavior, changes in health-related habits, and interference in the social, family, academic, or work spheres. These findings suggest that excessive Internet use is associated with the onset of several problems that are similar to those associated with other behavioral and technological addictions.     

Positive and problematic support,stress and quality of life in patients with systemic lupus erythematosus

Background and Objectives: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. Previous studies showed that perceived social support has an important role in enhancing patient's quality of life (QOL). However, the precise mechanisms through which social support exerts such an effect are not completely understood. The aim of this paper is to test two alternative models explaining the relationship between social support (positive and problematic) and two dimensions of QOL: Health-Related (HR-QOL) and Non-Health-Related (NHR-QOL). Design: Model A (mediation) hypothesized that positive support would reduce stress while problematic support would increase stress), and that this in turn would reduce QOL. Model B (moderation) hypothesized that the effect of support on QOL would be moderated by the experience of stress in that more stressed individuals would show stronger effects. Methods: Three hundred and forty-four Italian patients with SLE completed an online questionnaire. Results: Stress partially mediated the relationship between support and QOL dimensions (either HR-QOL and NHR-QOL) thus supporting Model B. As hypothesized, positive support reduced stress, while problematic support increased stress. Conclusions: These findings help to explain the complex relationship between social support, stress and QOL in patients with SLE.     

The association of parenting style and child age with parental limit setting and adolescent MySpace behavior

Parent and teen MySpace user pairs completed online surveys administered in June (N = 266) and September 2006 (N = 341) to assess relationships between parenting styles and limit setting and monitoring of online behaviors, the prevalence of Internet dangers and pre-teen and teen MySpace behaviors. Cross-comparison measures of MySpace usage, parenting style, limit setting/monitoring, MySpace problems, and media perceptions were used. Parenting styles were strongly related to adolescent MySpace experiences, behaviors, and attitudes, with some age differences. Parents with older children were more likely to have Neglectful or Indulgent parenting styles and less likely to set limits on online behavior. The extent of sexual solicitation, pornography, and cyberbullying was relatively low as compared with studies asserting a high incidence of Internet-related problems. Parents' high estimates of online dangers were not matched by their low rates of setting limits and monitoring teens. Theoretical and practical perspectives of the results are offered to enhance social networking experiences for parents and their children.     

Parents’ competitive stressors in professional German youth soccer academies: A mixed-method study

ObjectiveThis study was designed to identify parents’ competitive stressors in German elite youth soccer academies as well as their stressor-specific appraisals and emotions.Design and method330 parents (M_age = 46.0, SD = 6.2 years) completed a mixed-method online survey to indicate stressors encountered at their child’s competitions. Parental self-disclosed stressors were analyzed using qualitative content analysis (Mayring, 2014). Psychometric assessment of parents’ primary and secondary appraisal (PASA; Gaab, 2009) and emotions (SEQ; Jones et al., 2005) were subsequently used to conduct a stressor-specific analysis.Results and conclusionFrequency analysis yielded 831 competitive stressors of which the majority (47%) pertained to the own child, followed by those concerning other soccer parents (18%) or the child’s coach (15%). Univariate Analysis of Variance revealed coach-related stressors to be perceived significantly more as a challenge (primary appraisal) in contrast to situations with other soccer parents. Parents’ competency beliefs (secondary appraisal) were highest for stressors involving other soccer parents. Multivariate Analysis of Variance showed a significant difference in parents’ emotional experiences with coach-related stressors eliciting the highest anger scores. Parents’ stress experiences were characterized by circular causality and interdependency, suggesting a relational approach to stress for future studies. Implications are discussed to further guide theoretical advancements in the field of parental stress as well as to shape interactions and relationships within academy youth soccer.     

Posttraumatic stress severity is associated with coping motives for alcohol use among in-patient and community recruited adolescents

Background and Objectives: A growing body of work suggests individuals with more severe post-traumatic stress symptoms (PTSS) are at higher risk for developing problematic alcohol use outcomes. Extending work from the adult literature, the present study was the first to examine the extent to which PTSS is related to drinking motives for alcohol use in both clinical and non-clinical samples of adolescents.

Design: Hierarchical regression analyses were used to predict coping motives for alcohol use from PTSS, above and beyond demographic variables, alcohol use frequency, and other alcohol use motives.

Methods: Trauma-exposed adolescents before entering treatment (Sample 1 n?=?41) and recruited from the local community (Sample 2 n?=?55) self-reported on PTSS and alcohol use motives.

Results: PTSS positively predicted coping motives for alcohol use after controlling for age, gender, and alcohol use frequency.

Conclusions: The current study highlights the need to consider both PTSS severity, as well as underlying cognitive mechanisms (e.g., motives), to better understand the etiology of problematic alcohol use among trauma-exposed youth. Future work focused on clarifying the trajectory of alcohol use motives and problems as a function of PTSS is needed.     

Peer victimization through a trauma lens: Identifying who is at risk for negative outcomes

Peer victimization is a chronic stressor that occurs within the context of peer interactions and has been robustly associated with numerous negative psychological and social adjustment problems. Although increased frequency of peer victimization has been linked to psychosocial problems, few researchers have studied the role of duration and pervasiveness of victimization (i.e., number of places it occurs). The objective of this study was to examine how frequency, duration, and pervasiveness of peer victimization are associated with youth adjustment. Canadian adolescents (N = 879), ages 12–18 completed an online survey about experiences with peer victimization. Youth also answered questions about internalizing problems, distress, relationship quality with family, friends, and adults in their school and community, as well as academic functioning. Data were analyzed using multinomial logistic regression modeling. Both duration and pervasiveness of peer victimization were predictive of increased internalizing problems, distress, relationship problems, and academic difficulties. Duration and pervasiveness of peer victimization were identified as important factors to consider when predicting youth psychosocial adjustment. By asking questions about these situational factors, parents, teachers, and healthcare providers may more effectively identify youth who are at risk for experiencing mental health problems associated with peer victimization.     

Relationship between Facebook use and problematic Internet use among college students

The popularity of Facebook and other online social-networking sites has led to research on the potential risks of use, including Internet addiction. Previous studies have reported that between 8 percent and 50 percent of college students report problems consistent with Internet addiction. The current study assessed a range of variables related to Facebook use, and sought to determine how the use of Facebook relates to problematic Internet use. Undergraduate participants (N=281, 72 percent women) completed a battery of self-report measures, including the Internet Addiction Test, via an online interface. The results of the current study suggest that a sizable minority of students experience problems related to Internet use and that the use of Facebook may contribute to the severity of symptoms associated with Internet addiction.     

The experiences of gender diverse and trans children and youth considering and initiating medical interventions in Canadian gender-affirming speciality clinics

Abstract

Background: Canadian specialty clinics offering gender-affirming care to trans and gender diverse children and youth have observed a significant increase in referrals in recent years, but there is a lack of information about the experiences of young people receiving care. Furthermore, treatment protocols governing access to gender-affirming medical interventions remain a topic of debate.

Aims: This qualitative research aims to develop a deeper understanding of experiences of trans youth seeking and receiving gender-affirming care at Canadian specialty clinics, including their goals in accessing care, feelings about care and medical interventions they have undergone, and whether they have any regrets about these interventions.

Methods: The study uses an adapted Grounded Theory methodology from social determinants of health perspective. Thirty-five trans and gender diverse young people aged 9 to 17?years were recruited to participate in semi-structured interviews through the specialty clinics where they had received or were waiting for gender-affirming medical interventions such as puberty blockers, hormone therapy, and surgery.

Results: Young people felt positively overall about the care they had received and the medical interventions they had undergone, with many recounting an improvement in their well-being since starting care. Most commonly shared frustrations concerned delays in accessing interventions due to clinic waiting lists or treatment protocols. Some youth described unwanted medication side-effects and others said they had questioned their transition trajectory at certain moments in the past, but none regretted their choice to undergo the interventions.

Discussion: The results suggest that trans youth and gender diverse children are benefiting from medical gender-affirming care they receive at specialty clinics, providing valuable insight into their decision-making processes in seeking care and specific interventions. Providers might consider adjusting aspects of treatment protocols (such as age restrictions, puberty stage, or mental health assessments) or applying them on a more flexible, case-by-case basis to reduce barriers to access.